This review focuses on the role and mechanism of action of miR-26 in atherosclerosis, including the detection value of miR-26 and the potential development of drugs targeting its downstream genes, such as ACC1/2, COL1A1, CPT1A, FBP1, DGAT2, and SMAD7, to provide insight for drug development. The gene discussed is CPT1A; the disease is atherosclerosis.