Acute stroke-induced damage of endothelial cells leads to impaired cerebral microcirculation and significant damage of the brain tissue. Despite recent advances in treatment approaches that improve survival after a stroke, diagnostic approaches aimed at early identification of the pathogenetic stroke subtype remain limited. MicroRNAs are promising biomarkers in stroke. The article reviews data on the relationship of stroke with changes in the levels of certain circulating microRNAs and the opportunities for their diagnostic use.