To investigate the correlation between circulating microRNAs and liver injury indexes in drug-induced liver injury (DILI). We collected data on 72 DILI patients and 150 healthy subjects undergoing physical examination at our hospital from January 2021 to February 2022. From the diagnostic results, they were divided into a DILI group and a control group. Nano-magnetic beads were used to extract nucleic acid from serum, then qPCR was used to determine circulating microRNA levels, and the results were analyzed. Meanwhile, the serum liver function index levels before and after treatment were determined, and the correlations between circulating microRNA and these indexes were analyzed. We analyzed microRNA expression and found that miR-122-3p, miR-92a-3p, and miR-192-5p expression was consistent with a database, all of which were highly expressed in DILI. Moreover, after a period of treatment, their levels in circulation significantly decreased. ALT, ALP, GGT, AST, and TBIL also all decreased to different degrees after treatment. Multivariate analysis showed that the correlations between miR-122-3p and miR-92a-3p expression and ALT/AST index change were significant, as were the correlations between miR-192-5p expression and ALP/ALT/AST index change. This study showed that circulating microRNA expression levels in serum of DILI significantly increased and were positively correlated with the AST, ALP, and ALT expression levels. Circulating miRNA expression in serum can be used as a predictor and therapeutic index of DILI, which has high clinical value.