Mammalian cells are known to communicate with distant cells through extracellar vesicles such as exosomes and microvesicles. While microvesicles are formed by shedding of plasma membranes, exosomes are generated by the fusion of multivesicular endosomes (MVEs) with plasma membranes and release their internal intralumenal vesicles (ILVs) as exosomes. Recently, exosome research attracts great attention since exosomes play important roles in antigen presentation, propagation of cancer malignancy, and spread of neurodegenerative diseases. This review will present recent knowledge of the mechanism underlying exosome biogenesis based on sphingolipid metabolites including ceramide and sphingosine 1–phosphate (S1P). Current topics on neurodegenerative disorders such as alpha-synucleopathy in terms of insufficiency of S1P signaling is also briefly introduced.