MicroRNAs (miRNAs), small and noncoding RNAs that regulate gene expression through hybridization to messenger RNA, play a crucial role in the prevention or progression of non-alcoholic fatty liver disease (NAFLD). There is an urgent demand for the improvement of diagnostic tools and effective pharmacotherapies for the treatment of NAFLD, which can advance to cirrhosis and liver cancer. MiRNAs act as regulatory factors and noninvasive diagnostic agents for NAFLD, enabling the staging of the disorder, prognosis, and identification of pharmaco-therapeutic targets. NAFLD causes alterations in the expression patterns of hepatocyte miRNAs, with some specific miRNAs related to the upgrade from NAFLD to non-alcoholic steatohepatitis (NASH). These miRNAs can activate certain signaling cascade and exacerbate or improve NAFLD, additionally, act as hepatocellular signals or second messengers that transmit information between the liver and other systems. This study provides a comprehensive review of the most important miRNAs and their involvement in the pathophysiology and cellular signaling pathways related to NAFLD.