Implants made of porous titanium alloy and fabricated by 3D printing are increasingly used in clinical research. However, porous titanium alloys do not integrate very well with surrounding bone tissue, and bone ingrowth into the implants is not substantial. Schwann cells (SCs) and SC-derived exosomes can effectively promote nerve regeneration, but their role in bone tissue regeneration and repair has not been studied. Therefore, we added SC-derived exosomes to bone marrow stromal cell (BMSC) cultures and observed their effect on BMSCs in vitro; then, we combined exosomes with porous Ti6Al4V scaffolds and observed their effects on bone regeneration and repair in vivo. We found that SC-derived exosomes could promote the migration, proliferation and differentiation of BMSCs and that combining exosomes with porous titanium alloy can effectively improve the efficacy of titanium alloy scaffolds in bone repair. The combination of exosomes and porous Ti6Al4V implants may constitute a new therapeutic strategy for treating bone defects. (C) 2020 Published by Elsevier Inc.