The convergence of nanotechnology and extracellular vesicle (EV) research gives rise to Chinese herbal medicine-derived nanovesicles (CHMDNVs) that may serve as promising candidates in cancer therapy. Composed of lipids, proteins, nucleic acids, and diverse bioactive constituents, CHMDNVs can be isolated through various techniques; however, standardized protocols for their preparation remain to be established. CHMDNVs exhibit a favorable safety profile, with low toxicity, along with excellent stability and biocompatibility. Notably, their anticancer properties and tissue-specific targeting capabilities enable them to function both as intrinsic therapeutic agents, and as natural nanocarriers for targeted drug delivery. This review provides a comprehensive overview of results in this research field, including molecular composition, extraction and purification methods, therapeutic advantages, and preclinical applications of CHMDNVs in oncology. Furthermore, it outlines the limitations in current research, and suggests directions toward the clinical translation in the future.