MicroRNAs (miRNAs) are small non-protein-coding RNAs that negatively regulate gene expression. They bind to the 3'-untranslated region of specific mRNAs and inhibit translation or promote mRNA degradation. Dyslipidemia/hyperlipidemia is a well-accepted risk factor for the development of atherosclerosis. The pathogenesis factors involved in lipid abnormalities are being examined extensively, and there is emerging evidence linking miRNAs to lipid metabolism. Among them, recent studies, including ours, have demonstrated that miRNAs control the expression of genes associated with high-density lipoprotein (HDL) cholesterol (HDL-C) metabolism, including ABCA1, ABCG1, and scavenger receptor class B, type I. Moreover, HDL-C itself was proved to carry miRNAs and deliver them to several different types of cells. In this review, we describe the current understanding of the functions of miRNAs in HDL metabolism and their potential in therapy for treating cardiometabolic diseases.