Piwi-interacting RNA (piRNA) is a new class of small non-coding RNAs that function by specifically binding to the Piwi subfamily members of the Argonaute protein family. piRNA regulates the expression of target genes at epigenetic and post-transcriptional levels, and participates in the development and progression of cerebral ischemia by mediating pathophysiological processes such as inflammation, angiogenesis, and neuronal synaptic plasticity.