Extracellular vesicles are lipid bilayer-enclosed micro-vesicles generally existed in many biological fluids, and mediate molecular pathways and biological behavior of recipient cells by transferring various bioactive molecules to target cells, such as microRNA(miRNA). Recent studies have found that miRNA in extracellular vesicles plays an important role in the occurrence and development of atherosclerosis. This article reviews the selectivity of extracellular vesicular miRNA transfer in atherosclerosis, its regulatory role in the development of atherosclerosis, and its potential application in diagnosis and treatment.