Polycystic ovary syndrome (PCOS) is a common disorder of the female reproductive system. It is significantly associated with decreased fertility, and characterized by metabolic abnormalities such as hyperinsulinemia, insulin resistance, obesity, and hyperandrogenism. It is also associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease. Current therapies have limitations and are often ineffective, making it essential to explore new therapeutic approaches. Exosomes are extracellular membrane vesicles, released by cells, which play crucial roles in cell-to-cell communication. They transport various types of cargo, including lipids, proteins, mRNAs, miRNAs, and other noncoding RNAs. Since the cytokine effects of stem cells and their derived exosomes can offer protection against metabolic diseases, in this review we evaluate their potential use in the treatment of PCOS.