Essential hypertension is a chronic medical condition affecting thousands of people worldwide. It is polygenic and multi-factorial disease resulting from the interaction between genetic and environmental factors. Essential hypertension is implicated in cerebrovascular, cardiovascular and renal diseases. MicroRNAs are considered endogenous, non-coding regulators of gene expression by targeting specific mRNAs for degradation and/ or translational repression. MicroRNAs participate in a variety of developmental processes as metabolism, cell proliferation, and apoptosis. Many studies have reported the possibility of using miRNAs as new biological markers for polygenic diseases as cancer, stem cell aging, coronary heart disease, and essential hypertension. The stability of these miRNAs as miRNA let-7e, miRNA 296-5p, miRNA 605, and miRNA 623 in biological fluids makes them amenable to detection and quantification. This review summarizes the mechanisms by which miRNAs can control normal cellular processes and gene expression and the association of some circulating miRNAs with the incidence of different diseases, particularly essential hypertension.