Pre-eclampsia (PE) is a common hypertensive disorder of pregnancy with a significant impact on maternal and neonatal mortality and morbidity. While the pathogenesis of PE has been well described, identification of a biomarker(s) with robust predictive utility in identifying women at the highest risk of developing the condition has yet to be identified. In the search for diagnostic markers, those that may be obtained from the circulation are preferred alternatives to those derived from organ tissue samples. Because of their stability in plasma, microRNAs (miRNAs) have been explored as biomarkers in a host of disease states, although there is comparably little literature available on the circulating miRNAome of PE. This article provides a narrative review on the current state of knowledge on miRNAs associated with PE. Literature on circulating miRNAs is presented and the challenges to developing the diagnostic and prognostic utility of miRNAs in this context is discussed.