MicroRNAs (miRNAs) have emerged as pivotal regulators in the pathogenesis of oral cancer, offering promising diagnostic and therapeutic opportunities in precision oncology. Dysregulated miRNA expression profiles are reliable biomarkers for oral cancer diagnosis and prognosis. Specific miRNAs, including miR‐21, miR‐31, miR‐375, miR‐let‐7a, miR‐125a, and miR‐200c, show altered expression patterns linked to oral cancer diagnosis, staging, and prognosis. Furthermore, these differentially expressed miRNAs can be detected in readily available biofluids such as saliva and plasma, improving their utility as non‐invasive diagnostic tools. Aberrant miRNA expression contributes to crucial oncogenic pathways in oral cancer progression, metastasis, and drug resistance. Using miRNA mimics or anti‐miRNAs to manipulate miRNA expression provides a mechanism for influencing downstream target genes and sensitizing cancer cells to conventional chemotherapy or targeted therapies. Preclinical studies have demonstrated the efficiency of miRNA‐based therapeutics in suppressing the development of oral cancer cells and triggering apoptosis. Furthermore, miRNAs have been linked to medication resistance, opening up new options for improving therapy response in patients with oral cancer. Further research and clinical validation are warranted to fully exploit the theranostic potential of miRNAs in oral cancer management and advance precision oncology.