Skin is an important defense barrier of human body and one of the most vulnerable organs. Wounds are the result of damage to the integrity of skin. Chronic wounds and hypertrophic scar formation are the results of abnormal wound healing, and are also the clinical problems those need to be resolved urgently in the field of wound repair. In recent years, researchers have found that mesenchymal stem cells (MSCs) can promote wound healing, improve wound healing quality, and reduce scar formation. The therapeutic effect of MSCs may be derived from the exosomes derived from them. This paper reviews the research advances of exosomes derived from MSCs in wound healing and prevention and treatment of hypertrophic scars in recent years and looks up to the prospect for the clinical application.