Circulating microRNAs (miRNAs) are non-coding RNAs secreted into body fluids, and aberrant levels of these miRNAs correlate with diseases of various origins, making them highly potential clinical biomarkers. We investigated the spectrum of circulating miRNAs in the plasma of myelodysplastic syndrome (MDS) patients to identify miRNAs showing discriminatory levels in the patients with different prognosis. Plasma samples were analyzed with microarrays to define miRNA profiles, and the deregulated miRNAs were further studied using droplet digital PCR. With regard to the prognosis, the levels of miR-27a-3p, miR-150-5p, miR-199a-5p, miR-223-3p and miR-451a were reduced in higher-risk MDS. Multivariate analysis indicated miR-451a level as an independent predictor of progression-free survival (HR = 0.072, P = 0.006) and revealed a significant association of miR-223-3p level with overall survival (HR = 0.039, P = .032). Our data demonstrate that plasma levels of specific miRNAs are associated with MDS patient outcome and may add information beyond the currently used scoring systems.