Extracellular vesicles (EVs) secreted by Trichomonas vaginalis are now recognized as important mediators of host-parasite communication and play crucial roles in the development of trichomoniasis. These membrane-enclosed vesicles, which include exosomes and microvesicles, carry a diverse array of cargo, including proteins, lipids, and nucleic acids, as well as virulence-associated components such as adhesion molecules, proteases, and tRNA-derived small RNAs. Functionally, EVs enhance parasite attachment to vaginal epithelial cells, facilitate colonization, and contribute to host tissue damage. They also influence host immune responses, exhibiting both pro-inflammatory and immunosuppressive activities. Furthermore, the composition of EVs can be modulated by endosymbionts such as Trichomonasvirus, thereby influencing host-pathogen interactions. In addition, EVs mediate parasite-parasite communication, thereby promoting parasite adaptation and survival. This review summarizes current knowledge on the composition and functional roles of T. vaginalis EVs, highlighting their involvement in adhesion, immune modulation, and infection, as well as their potential utility as diagnostic biomarkers and therapeutic targets.