Neurotransmitters are chemical messengers facilitating communication between neurons and other target cells, such as muscles or glands. These precise chemical signals regulate essential bodily activities, including heart rate, respiratory rate, sleep regulation, muscle control, mood stabilization, cognitive processes, and the maintenance of general physiological equilibrium. Neurotransmitter transport is essential for the functioning of the nervous system and is crucial in treating and managing neurological disorders and neurodegenerative diseases. Neurotransmitter balance disruptions coming from overproduction, receptor failure, together with synaptic damage or enzymatic deficiencies, lead to Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, epilepsy, and mental disorders. Therefore, advancing neurotransmitter delivery strategies is essential, since they will address contemporary healthcare challenges. DNA nanotechnology started as a revolutionary scientific discipline that Nadrian Seeman introduced during the 1980s. DNA nanotechnology has evolved into a field that enables researchers to build programmable structures with diverse DNA components. DNA nanotechnology has transformed the set of tools that molecular biologists and bioengineers have to work with, allowing the bottom-up assembly of functional nanosystems. Among them, TDNs have the benefits of rigidity, controlled geometry, and functionalization accessibility. The applicability of these DNA-based scaffolds in biomedical research has also broadened enormously, particularly in the fields of regenerative medicine and targeted therapeutics. It has been noted in the past that they are effective in crossing the blood-brain barrier, regulating the immune response, and following certain receptor-mediated endocytosis pathways. The Tetrahedral DNA Nanostructure (TDN) is one of the most widely studied DNA nanostructures. Tetrahedral DNA nanostructures (TDNs) have recently become versatile, programmable nanoscale tools that can be used in stem cell biology and neuroengineering. Their biocompatibility, structural stability, and ability to deliver payloads make them outstanding candidates to guide mesenchymal stem cell (MSC) differentiation and neuroregeneration. Recent developments demonstrate that TDNs, upon conjugation with therapeutic molecules or peptides, can penetrate biological barriers, regulate cellular internalization, and rewire cell behavior in a highly spatial and temporally controlled manner. This manuscript outlines the structural design of TDNs, their interaction with neural environments, and how they can be used to induce stem cell fate decisions, with recent in vitro and in vivo results. TDNs stand out as preferred nanostructures because they demonstrate excellent structural stability and simple assembly methods, predictable geometries, high programmability, and outstanding compatibility with biological systems. TDNs demonstrate excellent characteristics that make them perfect candidates for biological and medical applications. The resistance of TDNs to nucleases enables them to preserve their structure and operational characteristics longer than linear DNA in biological systems and environments. The geometric structure of TDNs decreases electrical resistance while creating asymmetric membrane charges, enabling their cell uptake without requiring external targeting agents. The feature proves advantageous when drugs need to penetrate brain capillary endothelial cells and overcome the blood-brain barrier (BBB), representing a significant challenge in CNS drug delivery. Effective drug carriers must have six vital features: strong biocompatibility, high stability during transport, simple drug loading capabilities, specific targeting mechanisms, rapid cellular uptake, and minimal side effects. Drug carriers must demonstrate penetration capacity through biological barriers, including the BBB. The structural properties of DNA nanostructures, specifically TDNs, show all crucial characteristics, including low immunogenicity, and precise structural customization that boosts their drug carrier potential. The application of TDNs shows great promise for delivering neurotransmitters. Neuroengineering and the reprogramming of stem cells need efficient delivery systems. TDNs engage caveolin- and clathrin-independent endocytosis pathways, and topology (sharpness, curvature) can favor one pathway over the other. Quantum dot-loaded DNA icosahedra have been tracked in real time in living cells, and demonstrated improved retention and cytoplasmic stability of payloads. Enhanced uptake and retention has been realized further with pH-responsive or lipid-modified DNA nanostructures. In vitro studies have demonstrated >70% uptake in primary neuronal cultures and zebrafish models within 2 hours of administration. Their design allows better cellular uptake while carrying more neurotransmitters through the blood-brain barrier, which provides an effective treatment for Parkinson’s disease and other neurodegenerative conditions. Our recent study has confirmed that TDNs are effective carriers for delivering serotonin, epinephrine, and norepinephrine. The cellular absorption of TDNs proceeds through Clathrin-mediated endocytosis. The molecules are conjugated to TDNs by forming electrostatic bonds and hydrogen bonds. Neurotransmitters with positively charged amine groups in their protonated state are drawn toward DNA phosphates because they have negative charges. The DNA bases with oxygen atoms in their minor and major grooves form hydrogen bonds with neurotransmitter hydrogen atoms to create additional stability in the complex.