Objective To summarize the role of exosomal proteins in the occurrence, development, and diagnosis and treatment of pancreatic cancer (PC), 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. ResultProteins carried by tumor-derived exosomes, such as LGALS3BP, VSIG2, ZIP4, AEP, and GOT1, can effectively regulate the tumor microenvironment and influence cell behavior, playing an important role in the occurrence, progression, and metastasis of pancreatic cancer. Additionally, exosomal proteins can serve as potential biomarkers for the early diagnosis of pancreatic cancer. For example, exosomal membrane proteins GPC1 and DNAJB11 are 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.