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Recent studies show primary cilia (PCs), sensory organelles present on the surface of most mammalian cells, act as a critical regulators of brain homeostasis and signaling. PCs act\u00a0as a signaling hubs for pathways like G protein\u2013coupled receptor, Hedgehog, Wnt, and neuroinflammation. When PCs\u00a0are depleted or dysfunctional, they impair the processing of amyloid precursor protein, tau phosphorylation, synaptic signaling, and neuron\u2013glia communication, leading to tau tangles, neuroinflammation, and amyloid beta plaques that drive AD progression. Beyond their role in signal transduction, PCs also regulate\u00a0the biogenesis, release, and cargo selection of extracellular vesicles (EVs), and dysfunctional EV\u2013PC crosstalk may contribute to AD progression. Examining PC\u2010derived EVs offers pathway\u2010specific insights into early ciliary and neuroinflammatory issues. 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