Objective To explore the enhancement effect of low-intensity pulsed ultrasound （LIPUS） combined with adipose mesenchymal stem cells derived exosomes （ADSCs-Exos） on endothelial angiogenesis.Methods Adipose tissue from SD rats’ groins was obtained. The ADSCs were harvested by enzyme digestion and identified by the surface molecule.The ADSC-Exos were extracted from the supernatant of the 3rd generation ADSCs and the exosome was identified by transmission electron microscopy

Western blot and nanoparticle tracking and analysis technology.Human umbilical vein endothelial cells （HUVECs） were divided into control group，exosome group，LIPUS group and LIPUS+ exosome group，the cell counting kit 8 （CCK-8） assay，scratch test and tubule formation test were used to detect the effects of different treatments on the proliferation，migration and tube formation ability of HUVECs.Results ADSC-Exos were saucer shaped vesicle with uniform morphology

and expressed the membrane-labeled proteins CD9 and Tsg101

97.8 % of the particle size was 118.8±80.8 nm

which proves that the particle diameter was consistent with exosome size.The CCK-8 analysis showed that LIPUS+exosome group had the best enhancement of HUVECs proliferation compared with exosome group，LIPUS group and control group （OD value 1.882±0.138，0.646±0.034，0.631±0.027 and 0.462±0.036，P＜0.05）.The scratch test showed that the cell mobility of the LIPUS+exosome group was the highest compared with exosome group，LIPUS group and control group （migration rate were 87.7±4.5%，43.0±5.1%，34.7±2.3% and 25.1±2.0%，respectively.P＜0.05）.The tube-forming ability of HUVECs in the LIPUS+exosome group was higher than that of other groups，and the difference was statistically significant （P＜0.05）.Conclusion LIPUS combined with ADSCs-Exos could effectively promote the proliferation，migration and tube formation of HUVECs.