Alzheimer's disease （AD） is a neurological disorder that poses a serious threat to the health of the elderly population， with the incidence increasing every year and no cure available. It is of great significance to conduct in-depth research on the pathogenic causative mechanisms and to seek preventive and curative strategies. Neuroinflammation is considered to be an important pathological feature and cause of AD， and microRNAs （miRNAs） can affect upstream， midstream， and downstream factors associated with the Toll-like receptor 4 （TLR4） signaling pathway to regulate the level of neuroinflammation in the body. Numerous studies have shown that miRNAs as well as the TLR4 signaling pathway play important roles in neuroinflammation， and several specific miRNAs， including miR-34a-5p， miR-107-5p， and miR-146a， can target the TLR4 signaling pathway and participate in neuroinflammatory injury in AD. This paper focuses on how miRNAs affect neuroinflammatory injury in AD by regulating the TLR4 signaling pathway， and summarizes the Chinese and Western medicine treatment pathways targeting this signaling pathway， with a view to providing new ideas for AD prevention and treatment.