Circulating microRNAs (miRNAs) are exceptionally stable molecule markers in extracellular environments for various diseases. Importantly, some circulating miRNAs that were encapsulated in extracellular microvesicles (MVs) have been identified as critical mediators of intercellular communication, and function as novel cell-cell crosstalk generegulators. Burgeoning evidence has demonstrated that several types of viruses, including the human cytomegalovirus (HCMV), can encode various miRNAs that play essential roles in disturbing the translation of either the eukaryotic host's genes or virus own during multiple pathophysiological processes. Recently, HCMV-encoded miRNAs have also been uncovered in human circulation, moreover, some circulating HCMV-encoded miRNAs showed specific expression patterns in different diseases with no precise aetiology. In particular, dysregulated HCMV-encoded miRNAs can effectively regulate the host genes regulation, and were implicated in disease development. Given the clinical impact of circulating miRNAs and their abilities to profoundly modulate specific recipient cells, we postulate that characterization of altered HCMV-encoded miRNAs in host circulation may afford valuable insights into developing non-invasive diagnostic biomarkers and clarifying the potential pathophysiological mechanism for various complex diseases, even if the research on circulating HCMV miRNAs is just emerging. The focus of this review is on summarizing the updates on current developments and perspectives for diagnostic and discriminative usefulness of circulating HCMV-encoded miRNAs in various diseases, including essential hypertension, oral lichen planus disease, chronic hepatitis B and type 2 diabetes. We also review the physiological and pathophysiological effects of HCMV-encoded miRNAs on disease development and progression.