Abstract: Ischemic heart disease (IHD) is one of the leading causes of mortality worldwide. IHD is a form of congestive heart failure resulting from the imbalance between myocardial blood supply and oxygen demand, which is caused by different degrees of coronary artery obstruction. In response to the injury, nonischemic myocardium displays signs of secondary remodeling such as interstitial fibrosis and hypertrophy of cardiac myocytes. This remodeling process further deteriorates the pump function and increases susceptibility to arrhythmias. MicroRNAs (miRNAs) are small, noncoding RNAs that primarily function posttranscriptionally by interacting with the 3’untranslated region (UTR) of specific target mRNAs in a sequence-specific manner and regulate gene expression in a sequence-dependent manner. Recent research shows that miRNAs play important roles in the physiological and pathological processes of the heart, especially being involved in the occurrence and progress of myocardial infarction (MI) and post-MI remodeling. In this review we discuss how modulation of these miRNAs represents a promising new therapeutic strategy to improve the clinical outcome in IHD.