Atherosclerosis (As) is the main pathological factor of cardiovascular and cerebrovascular diseases. The pathological mechanism of the development of atherosclerosis has not been fully elucidated so far. Autophagy is a highly biological process in eukaryotic cells. Normal levels of autophagy inhibit the development of atherosclerosis, and autophagy defects or excessive autophagy accelerate plaque rupture, which lead to the occurrence of cerebrovascular accidents. Studies have shown that microRNA affects As processes by participating in the regulation of autophagy in As-related cells. This article reviews the role of microRNA in the regulation of autophagy levels in endothelial cells, macrophages, and smooth muscle cells in As.