Alzheimer's disease (AD) is a complex neurodegenerative disorder caused by multiple factors, characterized primarily by the deposition of amyloid β-protein (Aβ) plaques and the formation of phosphorylated Tau protein neurofibrillary tangles in the brain, which together lead to memory loss and cognitive impairment. In recent years, microRNAs(miRNAs), as an essential class of non-coding RNA molecules, have demonstrated a pivotal role in the pathogenesis of AD. miRNAs tightly regulate the generation and clearance of Aβ by targeting key genes such as APP and BACE1. Meanwhile, specific miRNAs can significantly influence the phosphorylation state of Tau protein, exerting a profound impact on neuronal stability and survival. However, despite the enormous potential of miRNAs in AD research, numerous challenges remain. For instance, the differences in miRNA expression patterns between AD patients and healthy controls, as well as their biological significance and translational relevance, require further validation. Additionally, there is currently a lack of unified and accurate criteria for assessing the reliability of miRNAs as biomarkers, and miRNA-based therapies have not yet been approved for clinical use. Therefore, future research needs to further delve into the specific mechanisms of miRNAs in AD, systematically evaluate their potential as therapeutic targets, and actively overcome existing technical and methodological challenges, in order to provide new theoretical foundations and practical strategies for the diagnosis and treatment of AD.