Although modern anticancer drugs have made great progress in disease treatment, the occurrence of drug resistance often leads to treatment failure. Understanding the molecular basis of resistance mechanisms is important to determine prognosis and develop strategies for circumvention. In this context, subcellular vesicles released by cancer cells have been identified to mediate cellular resistance by various mechanisms. Such extracellular vesicles (EVs) can be subdivided into exosomes and ectosomes based on their size, cargo, and mechanism of formation. The unveiling of EV-targeted treatment options depends on a sound knowledge on EV biology including biogenesis, release, targeting to recipient cells, and uptake. In this review, we focus on EVs as mediators of cancer drug resistance with a particular emphasis on the distinction of exosomes and ectosomes.