Aortic dissection (AD) is a serious cardiovascular disease with high mortality rate. It has the characteristics of rapid onset, rapid progress, complex and diverse manifestations, dangerous course, high mortality and poor prognosis. Although the specific pathogenesis of AD has not been fully elucidated, in recent years, microRNA (miRNA) has been found to play an important role in the occurrence and development of many cardiovascular diseases. Through the application of gene chip technology analysis and other related studies, it is found that there are significant differences in the expression of some microRNAs between AD patients and normal aortic tissues, which obviously contribute to the diagnosis of AD. Many studies have shown that miRNAs may play an important role in the pathogenesis and diagnosis of AD. This article reviews the research progress on differential expression and pathogenesis of miRNAs in AD.