Wearable ultrasound patches represent a new class of transdermal drug delivery systems, offering a minimally invasive, programmable, and user-friendly platform for personalized therapy and precision medicine. Here, we review recent advances in ultrasound-assisted transdermal drug delivery (UATDD) with an emphasis on acoustic mechanisms and device engineering. We describe the recent evolution of UATDD from early high-energy sonophoresis to sophisticated, skin-conformal platforms that exploit advanced acoustic modalities for precise, on-demand delivery. Key innovations include bulk-wave, surface acoustic wave, and acoustic vortex–based devices, alongside the synergistic integration of ultrasound with microneedles, which transforms the patch into a localized, in situ “bioreactor.” Looking forward, UATDD systems are poised to evolve toward fully autonomous, closed-loop wearable theranostic platforms that integrate real-time biosensing with AI-driven adaptive control, but challenges remain, including long-term biocompatibility, efficient wireless power management, and clear regulatory pathways. We believe UATDD patches hold significant potential to redefine disease management, shifting the paradigm from intermittent treatment to continuous, adaptive, and autonomous care.

Personalized pain medicine aims to tailor pain treatment strategies for the specific needs and characteristics of an individual patient, holding the potential for improving treatment outcomes, reducing side effects, and enhancing patient satisfaction. Despite existing pain markers and treatments, challenges remain in understanding, detecting, and treating complex pain conditions. Here, we review recent engineering efforts in developing various sensors and devices for addressing challenges in the personalized treatment of pain. We summarize the basics of pain pathology and introduce various sensors and devices for pain monitoring, assessment, and relief. We also discuss advancements taking advantage of rapidly developing medical artificial intelligence (AI), such as AI-based analgesia devices, wearable sensors, and healthcare systems. We believe that these innovative technologies may lead to more precise and responsive personalized medicine, greatly improved patient quality of life, increased efficiency of medical systems, and reducing the incidence of addiction and substance use disorders.

Extracellular vesicles are nano- to micro-scale, membrane-bound particles released by cells into extracellular space, and act as carriers of biomarkers and therapeutics, holding promising potential in translational medicine. However, the challenges remain in handling and detecting extracellular vesicles for disease diagnosis as well as exploring their therapeutic capability for disease treatment. Here, we review the recent engineering and technology advances by leveraging the power of sound waves to address the challenges in diagnostic and therapeutic applications of extracellular vesicles and biomimetic nanovesicles. We first introduce the fundamental principles of sound waves for understanding different acoustic-assisted extracellular vesicle technologies. We discuss the acoustic-assisted diagnostic methods including the purification, manipulation, biosensing, and bioimaging of extracellular vesicles. Then, we summarize the recent advances in acoustically enhanced therapeutics using extracellular vesicles and biomimetic nanovesicles. Finally, we provide perspectives into current challenges and future clinical applications of the promising extracellular vesicles and biomimetic nanovesicles powered by sound.