Extracellular vesicles (EVs) are mediators of extracellular communication, present in a diverse range of body fluids, with significant implications for a variety of physiological and pathological processes, including thrombosis, hemostasis, pregnancy, and neonatal health. Nanoparticle tracking analysis has allowed accurate and reliable detection of particles from 50 nm, to detect differences that provide insights into normal and diseased states. Specifically, EVs derived from platelets and endothelial cells play critical roles in vascular biology, sepsis, and inflammatory disorders. Additionally, placental EVs have been shown to influence pregnancy outcomes, with their altered profile contributing to the pathophysiology of complications such as preeclampsia (PE). As the technology for EV detection continues to improve, new avenues for studying their role in diverse clinical conditions are emerging. These advancements hold promise for the identification of novel biomarkers and therapeutic targets, offering the potential for improved diagnostics and personalized treatments in a variety of clinical settings.