Objective To delineate the mechanistic role of platelet-rich plasma (PRP)-derived extracellular vesicles (EVs) in tissue repair and regeneration, and evaluate their clinical translation potential. MethodsA systematic evidence synthesis was conducted through critical analysis of contemporary domestic and international literature, focusing on PRP-EVs’ biophysical properties, signal transduction networks, and multi-tissue regenerative efficacy. ResultsPRP-EVs coordinate hemostasis, anti-inflammatory modulation, angiogenesis, and tissue plasticity through mediation of cellular proliferation, migration, and differentiation. Their low immunogenicity and biostability constitute a novel cell-free therapeutic paradigm. ConclusionPRP-EVs exhibit substantial translational merit in regenerative medicine, yet persistent impediments in standardized isolation protocols, longitudinal biosafety verification, and clinical translation frameworks necessitate resolution.