Use the FolderFromPoint property to get the item from the point specified by the {X,Y}. The X and Y coordinates are expressed in client coordinates, so a conversion must be done in case your coordinates are relative to the screen or to other window. If the X parameter is -1 and Y parameter is -1 the ItemFromPoint property determines the handle of the folder from the cursor. This property is used to determine what folder is displayed at given coordinates. If given coordinates are pointing to background and not particular folder, 'Nothing' is returned. Note that Visual Basic all coordinates represents in 'twips', and the control accepts coordinates in 'pixels'. Therefore, all twips coordinates should be scaled to pixels when calling this method. ScaleX and ScaleY methods will do the job for you.

Below example displays the folder from the cursor:

Private Sub ExFolderView1_MouseMove(ByVal Button As Integer, ByVal Shift As Integer, ByVal X As Single, ByVal Y As Single)
    With ExFolderView1
        Dim f As EXFOLDERVIEWLibCtl.ExShellFolder
        Set f = .FolderFromPoint(-1, -1)
        If Not (f Is Nothing) Then
            Debug.Print f.DisplayName
        End If
    End With
End Sub