Autism spectrum disorder (ASD) is a neurodevelopmental condition that begins in early childhood and continues throughout life. Characteristics of ASD include social communication deficiencies and repetitive behaviors, and it affects individuals across various cultural, racial, and socioeconomic backgrounds, manifesting in a wide spectrum ranging from mild to severe. The condition’s cause is multifaceted and is determined by a combination of genetic, environmental, and immunological factors. The disease is influenced by various factors, including hormonal imbalance, immune system dysregulation, neuroinflammation, and mitochondrial dysfunction. An exact cause has yet to be identified. Assessment tools such as the Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition, the Childhood Autism Rating Scale, and the Autism Treatment Evaluation Checklist are used in diagnosis. Despite recent improvements in early diagnosis and behavioral treatments, a definitive cure for ASD has yet to be discovered. Strategies including psychotropic medications, talking therapy options, and occupational therapies are crucial in managing ASD. In recent years, cell therapies have emerged as prominent promising approaches. Cell-free therapy represents a novel approach to the treatment of ASD. This method utilizes exosomes produced from primary mesenchymal stem cells. These are small vesicles that carry bioactive molecules that have the potential to regulate the immune system, exert anti-inflammatory, antioxidative, and neuro-regenerative effects. The intriguing nature of these treatments is further enhanced by the ability of exosomes to cross the blood-brain barrier and facilitate intercellular communication. Due to the intricacies of ASD and the variety in treatment approaches, additional research is required to establish a conclusive treatment. Evaluation of the safety and efficacy of these treatments is ongoing, with additional clinical trials required to establish their long-term benefits.