Transcriptional co-repressor proteins have emerged as an important facet of cancer etiology. These co-repressor proteins are often altered by loss- or gain-of-function mutations, leading to transcriptional imbalance. Thus, research directed at expanding our present understanding of transcriptional co-repressors could impact the future development of new cancer diagnostics, prognostics, and therapies. In this review, our current understanding of the CtBP co-repressors, and their role in both development and disease, is discussed in detail. Importantly, the role of CtBP1 overexpression in adult tissues in promoting the progression of multiple cancer types through their ability to modulate the transcription of developmental genes ectopically is explored. CtBP1 overexpression is known to be pro-tumorigenic and affects the regulation of gene networks associated with “cancer hallmarks” and malignant behavior including: increased cell survival, proliferation, migration, invasion, and the epithelial-mesenchymal transition (EMT). As a transcriptional regulator of broad developmental processes capable of promoting malignant growth in adult tissues, therapeutically targeting the CtBP1 co-repressor has the potential to be an effective method for the treatment of diverse tumor types. While efforts to develop CtBP1 inhibitors are still in the early stages, the current progress and the future perspectives of therapeutically targeting this transcriptional co-repressor are also discussed.