Epigenetic modifications are heritable changes in genome function that occur without a change in DNA sequence. They turn genes on or off by small chemical modifications. Thereby, they change the structure of the DNA making them accessible or not for transcription factors or other DNA binding molecules. MicroRNAs are a new class of regulatory non-coding RNAs that modulate gene expression and influences epigenetic mechanisms. miRNAs offer novel mechanisms of therapeutic strategies for cancer and autoimmune diseases. Here, we summarize which miRNAs play a role in rheumatic diseases and their biological function.