Plant-derived nanostructures (PDNSs) represent a promising class of natural nanomedicines that integrate therapeutic and drug delivery functions. These self-assembled nanosystems, including nanoparticles, nanovesicles, exosomes, and nanofibers, leverage bioactive phytoconstituents to overcome limitations of synthetic biomaterials, such as immunogenicity and suboptimal targeting. PDNSs exhibit unique advantages like high biocompatibility, autonomous formation, and multi-modal functionality. This review examines their structural classification, fabrication methods and characterization techniques. PDNSs, synergistically combining inherent biological activities with engineered delivery properties, are revolutionizing conventional drug delivery systems and therapeutic approaches. Their applications expand into a remarkable spectrum of medical fields, demonstrating outstanding efficacy in oncology, inflammatory disorders, infectious diseases, and tissue engineering. Furthermore, PDNSs exhibit transformative potential in addressing complex neurological and metabolic conditions. Their eco-friendly production, low toxicity, and ability to penetrate biological barriers (eg, the absorption barrier and the blood-brain barrier) establish them as the next frontier in therapeutic development. This review critically evaluates the immense potential of PDNSs to bridge natural medicine and precision nanomedicine, offering translational insights for future applications.