Objective To summarize the role of exosomal proteins in the occurrence, development, and diagnosis and treatment of pancreatic cancer, providing a reference for the exploration of biomarkers and therapeutic targets in this field. MethodA systematic review of recent domestic and international literature on the mechanisms of exosomes and their proteins in pancreatic cancer was conducted. ResultsProteins carried by tumor-derived exosomes, such as galectin-3 binding protein, V-set andimmunoglobulin domain containing 2, Zrt- and Irt-like protein 4, aspartate aminotransferase 1, could effectively regulate the tumor microenvironment and influence the cell behavior, playing an important role in the occurrence, progression, and metastasis of pancreatic cancer. Additionally, exosomal proteins could serve as potential biomarkers for the early diagnosis of pancreatic cancer. For example, exosomal membrane proteins DNAJ heat shock protein family (HSP40) member B11, and glypican 1 were highly expressed in pancreatic cancer tissues, indicating their potential. ConclusionExosomal proteins are expected to become novel biomarkers and intervention targets for the early diagnosis and targeted therapy of pancreatic cancer, providing new ideas for improving the diagnosis and treatment of pancreatic cancer.