Peripheral nerve injury is one of the most common clinical diseases. Although the regeneration of the peripheral nerve is better than that of the nerves of the central nervous system, because of its growth rate restrictions after damage. Hence, the outcome of repair after injury is not favorable. Small RNA, a type of non-coding RNA, has recently been gaining attention in neural injury. It is widely distributed in the nervous system in vivo and a significant change in the expression of small RNAs has been observed in a neural injury model. This suggests that MicroRNAs (miRNAs) may serve as a potential target for resolving the challenges of peripheral nerve repair. This review summarizes the current challenges in peripheral nerve injury repair, systematically expounds the mechanism of miRNAs in the process of nerve injury and repair and attempts to determine the possible treatment of peripheral nerve injury.