Introduction Our investigation aims to appraise the neuroprotective impact of Bone Marrow-Mesenchymal Stem Cells (BM-MSCs) derived exosomes against Ag NPs-inducing neurotoxicity in rats. Materials and Methods Twenty-four albino rats were divided into 3 groups. Group I (control negative), Group II (intraperitoneally injected with Ag NPs for 28 days, whereas Group III (intraperitoneally injected with Ag NP and BM-MSCs derived exosomes. Results There was a marked elevation of Malondialdehyde (MDA) along with a reduction of brain antioxidants, Gamma-aminobutyric acid (GABA) and Monoamine Oxidase (MAO) in the Ag NPs receiving group. Ag NPs upregulated c-Jun N-terminal Kinases (JNK) genes and c-Myc and downregulated the tissue inhibitors of metalloproteinases (TIMP-1) and Histone deacetylase 1 (HDAC1) genes. Otherwise, the co-treatment of BM-MSCs derived exosomes with Ag NPs could markedly increase the rat’s body weight, activity and learning while, decreasing anxiety, restoring all the toxicological parameters and improving the microscopic appearance of different brain areas. Conclusion BM-MSCs-derived exosomes downregulated both apoptotic and inflammatory mediators and upregulated the antiapoptotic genes. BM-MSCs-derived exosomes exhibit a great therapeutic effect against the neurotoxic effects of Ag NPs.