The migrasome, an organelle that forms behind migrating cells, is connected to the cell body by a retraction fiber. Once released from the retraction fiber, the migrasome transforms into an extracellular vesicle and plays important roles in cell communication, development, angiogenesis, and disease. To date, the biogenesis, regulation of formation, cargo transportation, and physiological functions of migrasomes remain largely unknown. In this review, we summarize the current understanding of the mechanisms underlying migrasome formation and regulation, describe the evidence suggesting that migrasomes serve various physiological functions, compare the differences between migrasomes and other extracellular vesicles, emphasize the limitations in studying migrasomes, and discuss the potential of migrasomes in disease diagnosis and treatment.