Background: Measurement of the level of circulating microRNAs (miRNAs) has been introduced as a convincing diagnostic modality in a variety of diseases including acute heart failure (AHF). There are also a few encouraging results that advocate the prognostic value of miRNAs in AHF. Our aim in this study was to evaluate the diagnostic and prognostic value of selected miRNAs in patients with AHF. Method: Forty-four patients were randomly selected from AHF patients attending the Madani Heart Center of the Tabriz University of Medical Sciences from 1st April 2018 to 31st August 2018. 58 healthy participants were included as the control group. The plasma level of selected miRNAs including miR -1, -21, -23, and -423-5-p were measured in both groups. In the second phase, patients were followed for one year and several outcomes were recorded including in-hospital mortality, one-year mortality, and the number of readmissions. Result: An overall 102 plasma samples were evaluated. There was no significant difference in demographic characteristics between the two groups (p> 0.05). Mean levels of miR-1, -21, -23, and -423-5-p in AHF patients were significantly higher than the control group (p values=0.001, 0.002, 0.002, and 0.001, respectively). All selected miRNAs demonstrated high diagnostic power. The highest sensitivity and specificity were seen in miR-423-5-p which were 90% and >99%, respectively (p = 0.001, AUC = 0.909). The follow-up data demonstrated these miRNAs had no significant association with prognostic outcomes (p>0.05 for all variables). Conclusion: The result of our study demonstrated that miR-1, -21, -23, and -423-5-p can be considered as biomarkers with high sensitivity and specificity in AHF. However, we found no evidence supporting the efficacy of these miRNAs as prognostic factors.