Cutaneous squamous cell carcinoma (CSCC) is one of the most common cancers in the world. Although CSCC usually has a good prognosis, some patients show local recurrence, lymph node metastasis, distant metastasis, etc. Therefore, it is of great significance to actively seek new diagnosis and treatment methods for CSCC. Extracellular vesicles (EVs) are rich in proteins, nucleic acids, lipids and other bioactive substances, which play an important role in the physiological and pathological processes of the body by mediating intercellular communication. EV is closely related to the occurrence and development of skin squamous cell carcinoma, and is a potential marker for early diagnosis and targeted therapy of skin squamous cell carcinoma. This article reviews the research progress of CSCC-derived EV biogenesis and its role in the diagnosis, prognosis and treatment of CSCC, aiming to explore the potential value of EV in the clinical diagnosis and treatment of CSCC.