Ischemic stroke is a leading disease that is responsible for deaths and long-term disability all over the world. Intense research has been conducted to find suitable therapeutics and, so far, this quest showed no success. Current therapeutic approaches cover only two concepts, elimination of the cause of ischemia (thrombolysis or thrombectomy) and/or the rehabilitation to try to restore affected functions. No medication has shown promise in the prevention, reduction, or repair of damaged neural cells and the associated neurological functions. In some cases, a limited endogenous restoration of function has been seen following stroke in the brain, and stem cells-based therapeutic application has been shown to efficiently enhance this endogenous brain repair and improve the restoration of affected functions. Exosomes are nanosized vesicles that are produced by most body cells and carry beneficial cargo to transport them between cells. The focus of this book chapter is on the use of exosomes as potential diagnostic tools (containing various important markers) for ischemic stroke and, more specifically, on the recent interest in stem cells-derived exosomes as a promising therapeutic option for efficient neurorestoration following stroke.