Chronic exposure to heavy metals as aluminum chloride (AlCl3) could result in severe health hazards such as chronic renal injury. The present study aimed to evaluate the therapeutic potential of adipose tissue‑derived stem cells (ASCs) in comparison to their microvesicles (MV) in AlCl3‑induced chronic renal injury. Forty‑eight adult male Wistar rats were divided into four groups: Control group, AlCl3‑ treated group, AlCl3/ASC‑treated group, and AlCl3/MV‑treated group. Biochemical studies included estimation of serum urea and creatinine levels, oxidative biomarkers assay, antioxidant biomarkers, serum cytokines (IL‑1β, IL‑8, IL‑10, and IL‑33), real time‑PCR analysis of renal tissue MALT1, TNF‑α, IL‑6, and serum miR‑150‑5p expression levels. Histopathological studies included light and electron microscopes examination of renal tissue, Mallory trichrome stain for fibrosis, Periodic acid Schiff (PAS) stain for histochemical detection of carbohydrates, and immunohistochemical detection of Caspase‑3 as apoptosis marker, IL‑1B as a proinflammatory cytokine and CD40 as a marker of MVs. AlCl3 significantly deteriorated kidney function, enhanced renal MDA and TOS, and serum cytokines concentrations while decreased the antioxidant parameters (SOD, GSH, and TAC). Moreover, serum IL‑10, TNF‑α, miR‑150‑5p, and renal MALT1 expression values were significantly higher than other groups. Kidney sections showed marked histopathological damage in both renal cortex and medulla in addition to enhanced apoptosis and increased inflammatory cytokines immunoexpression than other groups. Both ASCs and MVs administration ameliorated the previous parameters levels with more improvement was detected in MVs‑treated group. In conclusion: ASCs‑derived MVs have a promising ameliorating effect on chronic kidney disease