Osteoporosis (OP) and osteoarthritis (OA) are clinically common chronic orthopedic diseases. With the aging of the global population, OP and OA pose a serious threat to human health. Exosomes are nanoscale vesicles secreted by cells and can mediate inter-cell communication. Recent research has shown that plant-derived exosomes-like nanovesicles (PELNs) can affect the proliferation and differentiation of osteoclasts, osteoblasts, bone marrow mesenchymal stem cells (BMSCs) and chondrocytes, regulate the immune system and inhibit inflammatory responses, and have potential value in treating OP and OA. This article summarizes the basic concepts, formation and components, separation and characterization methods of PELNs, and focuses on discussing the impact of PELNs on OP and OA, aiming to provide new ideas for the research of OP and OA.