Rheumatoid arthritis is a sysrenmic autoimmune disease which mainly affects joints that affects millions of patients in the world. Protein therapeutic is one of the important treatment against this disease. In order to perform precised protien delivery, engineered exosomes are significant tools. This review includes the pathophysiology of rheumatoid arthritis and therapeutic targets, introduction of exosomes, strategies of engineering exosomes and the evaluation of engineered exosome-based protein drug delivery systems. The research shows that exosome is a good material for target protein delivery due to its accuracy and biocompatibility. The efficiency is significantly increased comparing with other delivery system. However, there are still some limitation for this method, such as high cost and low cargo loading efficiency. This review calls for the medical industry's attention on this kind of new technique to improve the engineeringf strategies and reduce the costs, in order to put this method in use for more patients.