Introduction: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cardiovascular disorder and a leading cause of vascular mortality. MicroRNAs (miRNAs) are small endogenous noncoding RNAs that regulate gene expression post-transcriptionally by binding to the target messenger RNAs (mRNAs), inducing mRNA degradation or translational repression. miRNA dysregulation likely contributes to VTE pathogenesis. This review comprehensively summarizes current evidence on miRNAs in VTE, offering a structured overview of the existing literature. Materials and Methods: Eligibility criteria were defined using the Population, Intervention/Exposure, Comparator, Outcomes, and Study design (PICOS) framework. A comprehensive literature search in PubMed and EMBASE was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Given methodological heterogeneity, a narrative synthesis was undertaken. Results: Among the 156 studies included in this review, 99 investigated miRNAs in DVT, 25 examined the role of miRNAs in PE, and 32 evaluated miRNA involvement in VTE. These miRNAs were categorized as prothrombotic, antithrombotic, or unclassified based on their reported functional roles. Conclusions: This systematic review highlights the impact of miRNAs in the pathophysiology of VTE and provides a resource for future mechanistic and translational research. The findings emphasize the need for standardized, large-scale studies focusing on human-specific models to validate miRNAs as diagnostic, prognostic biomarkers, and as therapeutic targets in VTE.