Acute myocardial infarction(AMI) is an acute coronary artery occlusion characterized by coronary atherosclerosis，plaque rupture，and thrombosis.It has high morbidity and mortality，posing serious impacts on the society and families.AMI patients mainly present the syndrome of qi deficiency and blood stasis.Therefore，replenishing qi and activating blood are the main therapeutic principles for AMI.Buyang Huanwu Decoction，Qishen Yiqi Pills，and Shensong Yangxin Capsules are commonly used prescriptions.Studies have been conducted concerning the clinical symptoms and pathogenesis of the AMI patients with the syndrome of qi deficiency and blood stasis.Yiqi Huoxue Decoction can treat this disease in a multi-component，multi-level，and multi-target manner.It can promote angiogenesis，inhibit ventricular remodeling and cell apoptosis，protect vascular endothelium，reduce oxidative stress and inflammatory response，boost coronary blood flow，and alleviate traditional Chinese medicine(TCM) syndromes.Therefore，this prescription is widely used in the prevention and treatment of cardiovascular diseases.Moreover，by regulating the expression of related miRNAs，Yiqi Huoxue Decoction can treat AMI via several mechanisms，including regulating angiogenesis，myocardial cell apoptosis，and inflammatory response and reducing ventricular remodeling.Making clear its role in regulating the expression of these miRNAs helps to clarify the targeting mechanisms of TCM，which has a unique theory about the etiology，pathogenesis，and treatment of AMI.This paper reviews the progress in the mechanisms of Yiqi Huoxue Decoction in the treatment of AMI and related miRNAs in the last 5 years.