Extracellular membrane vesicles (MVs) 30-1000 nm in diameter and of varying cellular origins are increasingly recognized for their participation in a range of processes, including the pathogenesis of various diseases, such as: (1) atherosclerosis, (2) thromboembolism, (3) osteoarthritis (OA), (4) chronic renal disease and pulmonary hypertension, (5) tissue invasion and metastasis by cancer cells, (6) gastric ulcers and bacterial infections, and (7) periodontitis. MVs are derived from many different cell types and intracellular mechanisms, and perform different metabolic functions or roles, depending on the cell of origin.The presence of a metabolically active, outer membrane is a distinguishing feature of all MVs, regardless of their cell type of origin and irrespective of terminologies applied to them such as exosomes, microparticles, or matrix vesicles. The MV membrane provides one of the few protected and controlled internal microenvironments outside cells in which specific metabolic objectives of the host cell may be pursued vigorously at a distance from the host cell. MVs are also involved in various forms of normal and abnormal intercellular communication. Evidence is emerging that circulating MVs are good predictors of the severity of several diseases. In addition, recently, the role of MVs in inducing immunity against cancer cells and bacterial infections has become a topic of interest to researchers in the area of therapeutics. The main objective of this review is to list and briefly describe the increasingly well-defined roles of MVs in selected diseases in which they seem to have a significant role in pathogenesis.