Abstract: Brain injury, especially that caused by stroke, is a leading cause of morbidity and mortality worldwide. Numerous studies on the neuroprotective effects of neural stem cells (NSCs) after brain injury have shown that crosstalk among neural cells, including neuron–glial, glial–glial, NSC–neuronal and NSC–glial communication, plays a major role in post-injury repair. Therefore, a better understanding of the factors involved in the interactions between NSCs and other neural cells should advance the development of therapeutic strategies for brain injury. In this article, we discuss the role of exosomes in the crosstalk between NSCs and microglia, focusing on key exosomal proteins and microRNAs in brain injury progression and repair.