Pancreatic cancer (PC) is one the deadliest cancers worldwide. It is characterized by elevated mortality rates because of the lack of effective diagnostic methods, the dense stroma that shields the tumor from effective drug penetration, and the emergence of chemoresistance. Recent research has elucidated the role of PC-derived exosomes in driving and fueling PC progression, metastasis, and chemoresistance by transporting key molecules from tumor cells to recipient cells in the tumor microenvironment (TME). In this review, we delineate some of the key exosomal molecules involved in immune suppression and reprogramming of the TME, the establishment of metastatic niches, and drug resistance. We also explore the potential of exosomes as both diagnostic tools for early PC detection and management and as therapeutic targets.