MicroRNAs (miRNAs) are critical regulators of stroke pathophysiology, influencing neuroinflammation, neuronal survival, and post-stroke recovery. This study presents a comprehensive bibliometric analysis of 1,988 miRNA-stroke research articles published over the past 42 years, mapping the intellectual landscape, emerging research hotspots, and future directions within the field. Using Python, VOSviewer, and CiteSpace, we identified influential studies, leading authors, collaborative networks, and key thematic clusters that are advancing research. Our analysis highlights several emerging hotspots, including exosomal miRNA biomarkers for stroke diagnosis, miRNA-based therapeutics, and regulatory networks involving circRNAs and lncRNAs, which present promising avenues for precision medicine. Citation burst and timeline analyses highlight the growing focus on miRNA-targeted interventions, epigenetic modifications, and neuroprotective strategies, which are rapidly shaping the evolution of stroke research. Importantly, we emphasize the need for increased research in human-based studies to validate these findings and ensure clinical applicability. This study provides a structured framework to guide future research efforts, promoting international collaboration and bridging the gap between fundamental discoveries and the clinical translation of miRNA-based diagnostics and therapeutics in stroke.