Introduction: Exosomes play significant roles in transferring cargo materials like proteins, RNAs (including miRNAs), and DNA. However, the role of serum exosome shuttled RNAs and miRNAs in head and neck cancer (HNC) remains unclear. This study assessed the diagnostic and prognostic significance of exosomal miR-17, miR-20a, and TGFBR2 in HNC patients. Methods: Exosomes were isolated, from 400 confirmed HNC patients and 400 healthy controls, and characterized by NTA, TEM, Immunolabelling, and ELISA. Quantitative PCR was used to check the expressions of exosomal molecules. Oxidative stress was also measured through ELISA in cancer patients and healthy controls. Results: Data analysis revealed significant dysregulation in the expressional levels of miR-17 (p < .0001), miR-20a (p = .0003), and TGFBR2 (p = .0005), which were found associated with aggressiveness and poor survival of HNC patients. Spearman correlation revealed a positive statistically significant association between miR-20a versus miR-17 (r = 0.534; p < .01), while a negative correlation was found between TGFBR2 versus miR-17 (r = -0.240; p = .015). Significantly decreased levels of peroxidase (POD) (p < .0001) and an increased level of 8-Oxoguanine (p < .0001) were observed. Conclusion: The results showed that these exosomal miRNAs and target gene may serve as potential and noninvasive diagnostic and prognostic markers for head and neck cancer patients.