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 and regulate processes such as cell differentiation, apoptosis, autophagy, oxidative stress, and energy metabolism disorders, and is regarded as biomarkers for many diseases. In recent years, 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 article reviews the relevant regulatory pathways and effects of miRNAs in MIRI, and analyzed the therapeutic efficacy and molecular mechanisms of traditional Chinese medicine monomers, compound prescription and Chinese patent 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.