The invention relates to an exosome derived from human pluripotent stem cells, a preparation based on the exosome and use of the exosome and preparation, and belongs to the technical fields of cell biology, molecular biology and drug research and development. The human pluripotent stem cell exosome or the preparation based on the human pluripotent stem cell exosome has the uses of A, being an additive cultured in vitro for maintaining the stemness of adult stem cells and inhibiting the senility of the adult stem cells; B, being an additive cultured in vitro for maintaining the proliferative activity of various tissue primary culture cells; C, being applied in preparing medicine for treating bone and cartilage degenerative changes; D, being applied in preparing medicine for preventing the bone and cartilage degenerative changes; E, being applied in preparing medicine for treating orthopedic diseases such as osteonecrosis, bone nonunion, fractures, cartilage injuries, tendon injuries, frozen shoulders or tendon adhesion. Compared with the prior art, the exosome secreted by the pluripotent stem cells has powerful functions of promoting tissue cell regeneration, preventing senility andtreating bone diseases.