MicroRNAs (miRNAs) are small non-coding RNAs that play critical roles in the regulation of gene expression. In the context of heart valve development and disease, miRNAs have emerged as important regulators of cellular processes, including differentiation, proliferation, and apoptosis. This review explores the roles of various miRNAs in heart valve development and pathology, examining their mechanisms of action, potential as diagnostic biomarkers, and therapeutic targets. We summarize recent findings and discuss future directions for research in this evolving field.