Abstract: Viruses, as important biological agents influencing human health and social development, have played a key role in the spread of epidemics and the evolution of diseases since ancient times. Upon infecting hosts, viruses often trigger a series of complex responses, including innate and adaptive immunity, inflammatory responses and pathological damage. Despite advances in modern antiviral drugs development, chemical drugs typically rely on a single molecular target within the viral life cycle, making them highly susceptible to the emergence of drug resistance and the induction of systemic toxic side effects. In contrast, traditional Chinese medicines (TCMs), posing the distinctive advantage of multi-component, multi-target, and multi-pathway, have exerted a pivotal role in viral prevention and viral treatment. In recent years, fresh herbs have gained increasing attention for their ability to preserve intact bioactive components. Fresh herb-derived nanovesicles possess excellent biocompatibility, targeting and cross-species regulatory capabilities. These fresh herb-derived nanovesicles can effectively encapsulate and deliver a variety of antiviral components, demonstrating significant potential in antiviral immunomodulation, inflammation control and viral-induced pathologies. This review systematically sorts out the mechanisms of viral infection, and summarizes the advantages of fresh herbs, and the application prospects of fresh herb-derived nanovesicles in antiviral therapy. Furthermore, it focuses on summarizing the research progress of fresh herb-derived nanovesicles in the field of antiviral therapy, with the aim of providing insights and references for the development of fresh herb-derived nanovesicles-based antiviral strategies, as well as offering novel approaches and perspectives for the clinical treatment of viral diseases.