Atherosclerosis (As)-induced cardiovascular disease is one of the major complications and leading causes of death in patients with chronic kidney disease (CKD). MicroRNAs, a class of small non-coding RNAs, play important roles in gene regulatory networks. Numerous studies conducted both domestically and internationally have demonstrated that the abnormal expression of certain microRNAs can facilitate the pathological progression of CKD and its associated cardiovascular complications, such as As, through a variety of mechanisms and are identified as pathologically significant contributors to CKD As. Applying the unique advantages of microRNAs as disease biomarkers and the role of potential therapeutic targets of CKD As is a modern research hotspot. According to TCM, CKD As is characterized by a combination of positive deficiency and negative realities, and is characterized by the deficiency of the original and the symptoms. It is important to use microRNA as an entry point to study the specific mechanism of CKD As in Chinese medicine. The correlation between microRNAs and the pathological mechanism of CKD As as well as the research progress on the mechanism of action of Chinese medicine compound and Chinese medicine active ingredients in regulating the abnormal microRNAs of CKD to prevent and treat As were reviewed, in order to provide theoretical reference for future related research, so as to develop more effective therapeutic strategies and provide new possible pathways and intervention targets for clinical Chinese medicine treatment of CKD As.