• BMSC-derived apoptotic vesicles (ApoVs) significantly improve hindlimb ischemia by promoting angiogenesis.
• ApoVs are internalized by HUVECs via dynamin-, clathrin-, and caveolin-mediated endocytosis.
• Mechanistically, ApoVs transfer NAMPT to endothelial cells, activating the NAMPT/SIRT1/FOXO1 axis.
• This study provides a novel cell-free therapeutic strategy for chronic limb-threatening ischemia (CLTI).