Abstract: Exosomes are a class of lipid bimolecular microvesicles with a diameter of approximately 40–100 nm, actively secreted by various cells. Exosomes can carry specific bioactive molecules, such as proteins, lipids, microRNA, and lncRNA, into the corresponding target cells, thus mediating material transport and information communication between cells. LncRNA is a class of single-stranded RNA molecules without protein-coding function that regulates gene expression at epigenetic, transcriptional, and post-transcriptional levels and participates in tumor proliferation, invasion, metastasis, drug resistance, tumor immune regulation, and other processes, thus affecting the occurrence and development of tumors. Studies have shown that exosome-derived lncRNA is involved in the occurrence, invasion, and metastasis of colorectal cancer, thus playing an essential role in the diagnosis, prognosis, and treatment of colorectal cancer. This review summarizes the role of exosome-derived lncRNA in the development of colorectal cancer and related research progress in its diagnosis, prognosis evaluation, and treatment.