Atherosclerosis (As) is the main pathological basis of cardiovascular and cerebrovascular diseases, which seriously threatens human life and health. As occurs in abnormal shear stress sites, and microRNAs regulated by shear stress are called “shear stress sensitive microRNAs”. Shear stress-sensitive microRNAs are involved in many aspects of the pathogenesis of As. This review summarizes the recent advances in the mechanism of shear stress-sensitive microRNAs in the development and progression of As.