Atherosclerosis is widely appreciated to represent a chronic inflammatory disease of the vessel wall. As part of the inflammatory infiltrate, monocytes/macrophages contribute to the pathogenesis of atherosclerosis. Given the functions of microRNAs as key regulators of cellular functions, such as proliferation, differentiation and cytokine responses, it is conceivable that miRNAs expressed in inflammatory cells would also control disease progression, and circulating miRNAs detected in blood, apoptotic bodies and microvesicles may affect plaque cells and be useful as disease biomarkers. In addition, also epigenetic mechanisms contribute to the regulation of gene expression. We have characterized the expression profile of miRNAs in human plaque tissue and circulation monocyte subsets, and have investigated DNA methylation and corresponding methyltransferases in early and advanced human atherosclerotic carotid lesions and serum of patients with high grade carotid artery stenosis in comparison to healthy individuals. Given the importance of the delicately orchestrated immune response in atherosclerosis, miRNAs expressed in immune cells and epigenetic modifications will likely have profound effects during the evolution of lesion formation and constitute possible targets for therapeutic interventions.