MicroRNA regulation and expression has become an emerging field in determining the mechanisms regulating a variety of inflammation-mediated diseases. Recent studies have focused on specific microRNAs that are differentially expressed in case of osteoarthritis. Furthermore, several targets of these miRNAs important in disease progression have also been identified. In this review, we focus on microRNA biogenesis, regulation, detection, and quantification with an emphasis on cellular localization and how these concepts may be linked to disease processes such as osteoarthritis. Next, we review the relationship of specific microRNAs to certain features and risk factors associated with osteoarthritis such as inflammation, obesity, autophagy, and cartilage homeostasis. We also identify selected microRNAs that are differentially expressed in osteoarthritic tissue, but have unidentified targets and functions in the disease pathogenesis. Lastly, we highlight the potential use of microRNAs for therapeutic purposes, and also point to certain remedies that regulate microRNA expression.