Abstract: Ovarian cancer is the most lethal gynecological malignancy, for which chemotherapy is one of the main treatments at present. However, long-term use of chemotherapeutic drugs usually results in drug resistance in ovarian cancer, leading to treatment failure and tumor progression, which accounts for the low effectiveness of clinical therapy. The mechanism of drug resistance and the strategy of prevention or reversal of such resistance have been focal topics in ovarian cancer therapy researches. Exosomes are small spherical extracellular vesicles secreted by cells with a diameter of 40~100 nm. Exosomes carry a variety of biomolecules (including DNA, non-coding RNA, and proteins) and take part in a variety of physiological and pathological communications. This article reviews the role and mechanism of exosomes in the development of drug resistance in ovarian cancer, and aims to provide new insights for the prevention or treatment of drug resistance.