Vascular calcification is associated with an increased risk of death from cardiovascular disease, however vascular calcification is common in patients with coronary artery disease. The pathogenesis of vascular calcification is similar to the process development of bone and chondrogenesis. Vascular smooth muscle cells transdifferentiate into osteoblast-like cells, the imbalance of calcium and phosphorus adjustment, osteoclast activity and the decrease of mineral absorption capacity play an important role in promoting vascular calcification. It is now found that microRNA are involved in the process of vascular calcification by directing vascular smooth muscle cells for complex genetic reprogramming and other cellular functional responses associated with vascular calcification. This article presents in detail the important regulation that has so far involved microRNA-mediated vascular calcification.