MicroRNAs are small post-transcriptional regulators that play an important role in nervous system development, function and disease. More recently, microRNAs have been detected extracellularly and circulating in blood and other body fluids, where they are protected from degradation by encapsulation in vesicles, such as exosomes, or by association with proteins. These microRNAs are thought to be released from cells selectively through active processes and taken up by specific target cells within the same or in remote tissues where they are able to exert their repressive function. These characteristics make extracellular microRNAs ideal candidates for intercellular communication over short and long distances. This review aims to explore the potential mechanisms underlying microRNA communication within the nervous system and between the nervous system and other tissues. The suggested roles of extracellular microRNAs in the healthy and the diseased nervous system will be reviewed.