Abstract <p>Membrane-bound extracellular nanovesicles (ENVs) are a natural product of the secretory activity of living cells. One of the main biological functions of ENVs is considered to be intercellular transport. The size, stability, possibility of surface modification, and other characteristics indicate the possibility of using ENVs as a drug delivery system. The introduction of “vesicular” drug formulations into practice involves the development of a set of complementary technologies: obtaining ENVs, forming a vesicular dosage form, modifying the vesicular surface in accordance with the therapeutic purpose and the method of administration of the finished product. These aspects are covered in this review based on an analysis of studies devoted to the development of anticancer drugs. The final chapter discusses the stages of development and implementation of vesicular drug delivery systems into clinical practice.</p>