This Open Access book provides a focused translational roadmap on mesenchymal stem cells (MSCs) and MSC-derived extracellular vesicles (MSC-EVs), covering their biology, molecular cargo, isolation and characterization, mechanisms of action, preclinical evidence, clinical translation, and GMP/regulatory considerations. The book emphasizes the current shift from cell-based therapies toward cell-free therapeutic platforms and critically evaluates the opportunities and limitations of MSC-EV-based interventions in regenerative medicine. The intended audience includes stem cell and extracellular vesicle researchers, translational scientists, and investigator-clinicians working in regenerative medicine. The book can also serve as a useful resource for clinician-scientists, biotechnology developers, regulatory professionals, and graduate students in stem cell biology, translational therapeutics, and biomedical sciences.