Atherosclerosis is a chronic inflammatory disease of the arterial wall. It is characterized by subendothelial accumulation of low-density lipoprotein cholesterol, and its subsequent modification at athero-prone areas leads to further activation of the vascular wall and maintains vascular inflammation. An entirely new level of post-transcriptional gene regulation through microRNA (miR) expression has emerged recently as an important mechanism in the development and progression of numerous diseases, including atherosclerosis. Recently, miR-33a/b have been shown to act as post-transcriptional regulators of lipid metabolism, and their pharmacological inhibition diminished atherosclerosis by raising plasma high-density lipoprotein levels. This review summarizes the current understanding of the functions of miR-33a/b and the progress in miRNA therapeutics for treatment of various diseases, including atherosclerosis.