Abstract: Alzheimer′s disease (AD) is a chronic neurodegenerative disease that severely affects the quality of life of the elderly. Its main pathological features include the deposition of β-amyloid protein to form senile plaques, neurofibrillary tangles caused by abnormal phosphorylation of tau protein, as well as extensive neuronal loss and synaptic dysfunction. In recent years, mesenchymal stem cells (MSCs) and their exosomes (MSC-Exos) have attracted extensive attention due to their potential in the treatment of neurodegenerative diseases. MSCs possess multidirectional differentiation potential, immunomodulatory capacity, and significant neuroprotective and repair effects. As an important signaling mediator of MSCs, MSC-Exos are a type of nanoscale double-layer membrane-structured vesicles secreted by MSCs, capable of carrying and delivering various bioactive substances. MSCs and their derived MSC-Exos have demonstrated good safety and efficacy in the treatment of AD. This article systematically reviewed the basic and translational research progress on MSCs and MSC-Exos in the treatment of AD in recent years.