Non-coding RNAs, especially microRNAs (miRNAs), have been recently found to play a major role in the post-transcriptional regulation of both development and dysfunction of the cardiovascular system. Mechanistically, the induction or repression of miRNAs occurring in cardiovascular dysfunction triggers downstream cardiac events in a cell-type-specific manner. More importantly, the endogenous microRNAs' disturbance can be modified to rescue cardiac function through exogenous overexpressing or neutralizing strategy. In this paper, we summarizes the current knowledge about miRNAs functions as well as their role in cardiac development and disease, and reports novel miRNAs-based therapeutic approaches to counteract maladaptive remodeling upon cardiac dysfunction.