Adaptive change in vascular wall structure is known as vascular remodeling, which can occur in arterial hypertension, aneurysms, restenosis after vascular intervention and atherosclerosis. MicroRNAs (miRs) play an important role in regulating the major cytokines involved in arterial remodeling, which may promote or inhibit the changes of vascular wall structure, regulate the phenotype of smooth muscle cells (SMC), and control the inflammatory response of endothelial cells and macrophages. Different types of miRs induce SMC to be contractile or synthetic, respectively; SMC is mainly induced to be synthetic during arterial remodeling. Thus, remodeling process can be regulated by reprogramming SMC phenotypes via targeted miRs. In addition, the stimulations of inducing endothelial cell remodeling, such as shear stress, angiotensin Ⅱ, oxidized low density lipoprotein and cell apoptosis, are mediated by miRs. For example, endothelial cell-specific miR-126 is transferred in microvesicles of apoptotic endothelial cells and plays a protective role in the formation of atherosclerosis; it promotes arterial remodeling, especially through the inflammatory response of the innate immune system of macrophages. MiR-155 induces the expression of inflammatory cytokines, while miR-146a and miR-147 participate in the elimination of inflammation. However, data on the role of miRs in vascular remodeling are still lacking, because it is necessary to test the therapeutic potential of currently available and highly effective miR inhibitors for cardiovascular diseases.