The function of microRNAs (miRNAs) as regulators of gene expression, their translational use as diagnostic biomarkers, and their potential as therapeutic targets for a number of diseases have all been the subject of much research in recent decades. By influencing the expression of genes involved in the production of tight junction proteins, miRNAs play a critical role in controlling intestinal epithelial transport. This directly affects the intestinal epithelium’s barrier function and the movement of molecules across the intestinal lining; in other words, depending on which genes they target and regulate, miRNAs can either promote or inhibit the transport of substances. The onset and spread of colorectal cancer (CRC) are also significantly influenced by miRNAs. The miRNAs have two distinct roles in CRC, depending on the genes they target. They can either operate as oncogenes or tumor suppressors, depending on the cellular environment. Their influence also includes influencing important aspects of the pathophysiology of CRC, including as angiogenesis, apoptosis, chemoresistance, proliferation, and sensitivity to radiation. These miRNAs have the ability to influence pathways such as Wnt, TGF-β, PI3K-AKT, MAPK, and EMT, which makes them promising targets for therapy and clinical biomarkers. With a clear context, this chapter outlines current findings about miRNAs, including their function in intestinal transport of human epithelial cells, the process by which CRC progresses and spreads, and their potential as biomarkers and therapeutic targets in CRC. The roles of miRNAs in carcinogenesis and development were also integrated with CRC patient care, resulting in new insights into the diagnosis and management of CRC.