Objective To investigate the effect of anti-tuberculosis drug-induced hepatotoxicity (ATDH) on the expression of miRNA in patients′ plasma. Methods The plasma from 3 patients with ATDH was collected and subjected to miRNA microarray analysis before anti-tuberculosis treatment and after liver injury during drug therapy. The differentially expressed miRNAs were verified using real-time quantitative PCR. The target genes of miRNAs were predicted by the Internet software, and the GO functional classification of target proteins were found by the PANTHER protein classification system. Results After ATDH had occurred, the microarray screened 22 differentially expressed miRNAs compared to those of pretreatment, among which 11 were up-regulated, and 11 were down-regulated. Real-time quantitative PCR results showed that after ATDH there were 5 up-regulated miRNAs, namely miR-378i, miR-125b-5p, miR-1224-5p, miR-194-5p and miR-34a-5p, and 3 down-regulated miRNAs, namely miR-1260a, miR-338-3p and miR-4286. Conclusion There are differentially expressed miRNAs in the plasma of patients after ATDH, and these miRNAs may be related to the incidence of ATDH.