Abstract: Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy in adults, characterized by spontaneous recurrent seizures, with most patients experiencing drug resistance and cognitive dysfunction. MicroRNAs (miRNAs) play a critical role in the pathological process of TLE through their regulation of post-transcriptional gene expression. The pathogenesis of TLE has not been fully elucidated, lacking effective clinical therapeutic targets and prognostic markers. This review summarized the expression changes of miRNAs in TLE and their research progress as potential biomarkers, aiming to provide new insights into the early diagnosis, prognosis evaluation, and pathogenic mechanisms of TLE.