Kawasaki disease(KD) is a febrile vasculitis in childhood.It has become the most prominent cause of pediatric secondarycardiovascular disease as it is associated with coronary artery lesion(CAL). Even though intravenous immunoglobulintreatment has greatly lowered the incidence of coronary arteryaneurysm, the existence of IVIG-resistant KD indicates a part of patients are still at a high risk of CAL, which brings them a huge psychiatric and financial burden.Therefore, studying the pathogenesis of CAL associated with KD is of great significance.This article reviews the related mechanism of KD and the associated CAL.Meanwhile, it illustrates the connection between microRNA-208 and CAL, on which basis the perspective of microRNA-208 possibly involving in the KD-associated CAL is given.