Recent studies have revealed that extracellular vesicle (EV), as membrane‑derived natural nanoscale vesicular structures, can be involved in the development of chronic pain (CP) through a variety of molecular signals they carry. This paper focuses on the mechanism of EV in the regulation of CP, discusses EV' duality in the regulation of pain, and introduces EV' status and prospects in the diagnosis and treatment of CP, with the aim of providing new research ideas for the targeted treatment of CP.