Non-coding RNAs (ncRNAs) are now recognized as crucial regulators of cancer biology, influencing gene expression and acting as oncogenes or tumor suppressors. They influence essential cellular processes like proliferation, apoptosis, metastasis, and immune evasion, actively contributing to tumor initiation and progression. Their stability and specificity in biological fluids render them attractive non-invasive biomarkers, providing valuable insights into tumor dynamics. Beyond their diagnostic and prognostic roles, ncRNAs are also emerging as therapeutic targets, with strategies being developed to inhibit oncogenic ncRNAs or restore the function of tumor-suppressive ones using antisense oligonucleotides, small molecules, or RNA mimics. Despite the promise, challenges related to delivery, specificity, and standardization still restrict their use in clinics. Additionally, variability in sample handling, detection methods, and data normalization limits reproducibility across studies. However, the integration of ncRNAs into precision oncology has the potential to enable earlier detection, real-time monitoring, and more personalized treatments. Ongoing research continues to explore the therapeutic potential of ncRNAs, aiming to overcome current limitations and improve cancer management.