Abstract: Myocardial ischemia reperfusion injury(MIRI) is further myocardial damage induced by blood flow restoration following myocardial infarction, which involves a variety of complex cellular and molecular mechanisms, and has become one of the serious complications affecting the prognosis and regression of patients with cardiovascular diseases. Currently, effective preventive and therapeutic measures are still lacking in clinical practice. MicroRNA(miRNA) can target cell differentiation, apoptosis, autophagy, oxidative stress, and energy metabolism disorders, and are regarded as biomarkers for many diseases. In recent years, with the deepening of related research, an increasing number of miRNAs have been found to play a key regulatory role in the occurrence and development of MIRI. Traditional Chinese medicine has the advantages of multi-target and multi-level effects in treating MIRI. This paper summarized the relevant regulatory pathways and effects of miRNAs in MIRI, and analyzed the therapeutic results and molecular mechanisms of traditional Chinese medicine monomers, compound prescription and proprietary Chinese medicines on MIRI by targeting miRNAs, aiming to provide references for translating basic research on traditional Chinese medicine treatment of MIRI into clinical practice and expanding clinical ideas.