Peripheral artery disease (PAD) is a vascular problem of diffuse atherosclerosis and is a major cause of cardiovascular morbidity and mortality. Many studies have tried to gain insight into the molecular mechanisms involved in PAD. Lately, highly stable circulating small noncoding RNAs, microRNAs (miRNAs), seem to have disease-specific expression. Thus, miRNAs are emerging as new measurable diagnostic biomarkers and a start point for individualized treatment. To date, the association of miRNA regulation in angiogenesis and maintenance of vascular integrity in PAD has attracted little interest. In this review, we will provide an overview of studies regarding the roles of specific miRNAs in PAD and their potential to act as a minimally invasive tool for diagnosis and risk stratification.