Atherosclerosis (As) is a chronic inflammatory disease triggered by various risk factors and is the main pathological basis of cardiovascular and cerebrovascular diseases. In recent years, the incidence of As has been increasing, but its pathogenesis remains unknown. Therefore, it is of great significance to explore the pathogenesis of As for early detection and treatment of the disease. As an important mediator of intercellular communication, exosomes plays an important role in the process of As. Micro RNA (miRNA) is involved in the formation of As as a key signal transduction and molecular regulation pathway. Therefore, this article reviews the regulatory role of exosomes inclusion miRNA in the formation and development of As.