Exosomes are nanoscale (approximately 30~150 nm in diameter) lipid bilayer membrane vesicles secreted by cells, rich in various bioactive substances with important biological functions, including proteins, nucleic acids, lipids, and small molecules. Plant-derived exosome-like nanoparticles (PELNs) from food-medicine homologous plants have recently become a focus of research in the biomedical field owing to their excellent biological activity, good biocompatibility, and potential therapeutic application value. This paper provides detailed summaries of the extraction and identification methods for exosomes from foodmedicine homologous plants, physiological activities of common components in PELNs, and current research on the efficacy of food-medicine homologous PELNs. It aims to deepen the understanding of the functional value of food-medicine homologous exosomes and to provide technical support for the development and utilization of exosomes, thereby offering a theoretical basis for the development of resources in the field of functional foods.