Background Anthracycline treatment often causes cardiotoxicity in breast cancer patients. Imaging and cardiac biomarkers are now used as criteria for cardiotoxicity. However, new biomarkers to aid in early detection are needed. MicroRNAs (miRNAs) are a class of tiny, non-coding RNA molecules with a significant function in controlling how genes are expressed. Several microRNAs (miRNAs) have been linked to cardiovascular illness and are being studied as indicators for cardiotoxicity caused by cancer treatments. Methods Medline/PubMed, Cochrane Central Register of Controlled Trials, Scopus, Lilacs, Web of Science, and Embase were all searched systematically, and they will remain open until April 2020. Included were cohort studies reporting miRNA biomarkers in breast cancer patients with and without anthracycline-induced cardiotoxicity. In addition, we looked through miRTarBase for miRNA-target interactions that have been verified in the lab. Results Only five of the 209 studies that were found met the requirements for inclusion. Two population-based cohorts confirmed the validity of Let-7f, miR-1, miR-20a, miR-126, and miR-210. In the epirubicin-cardiotoxicity group, compared to the non-cardiotoxicity group, the levels of the pro-angiogenic miRNAs let-7f, miR-20a, miR-126, and miR-210 were considerably lower. Although alterations in miR-1 levels have been debated in doxorubicin-treated breast cancer patients with cardiotoxicity, they have been demonstrated to give diagnostic and prognostic information in the context of myocardial infarction. Target genes for let-7f, miR-1, miR-20a, miR-126, and miR-210 were used to compile a cardiotoxicity-related reactome pathway. Conclusion In breast cancer patients undergoing chemotherapy with anthracyclines, the evidence suggests that let-7f, miR-1, miR-20a, miR-126, and miR-210 are linked to cardiotoxicity.