Ischemic stroke is a cerebrovascular disease with high disability and mortality, and can be life-threatening in severe cases, which has a heavy social and economic burden worldwide. The etiology and pathological process of ischemic stroke are mediated by a variety of molecular processes, and some of these molecular mechanisms are dynamically regulated after transcription. Increasing evidence has shown that Micro-ribonucleic-acid (miRNA), as an important mediator of post-transcriptional gene silencing, plays a crucial role in gene expression and the pathological process of ischemic stroke. In this review, we present the neuroprotective effects of mirnas in different mechanisms of ischemic stroke. Since the promotion or inhibition of miRNA expression through specific drug and non-drug therapy may be beneficial to the recovery of ischemic stroke, the clinical diagnosis and treatment of miRNA in ischemic stroke are also discussed in detail in this paper, aiming to provide a certain reference for clinical and basic research in this field.