Hamadan University of Medical Sciences Avicenna Journal of Medical Biochemistry 2345-4113 13 2 2025 12 31 MicroRNAs as Clinical Markers for Diagnosis and Therapeutic Targets in Bladder Cancer 113 126 10.34172/ajmb.2640 EN Nazi Aghaalikhani https://orcid.org/0000-0001-6997-4362 Fahimeh Yasari https://orcid.org/0000-0002-7066-4182 Roya Moeinzadeh https://orcid.org/0000-0002-8460-341X Mohammad Taghi Goodarzi https://orcid.org/0000-0002-5546-5812 REVIEW 10.34172/ajmb.2640 2025 11 15 2025 12 31 This review investigated the evidence regarding the expression of microRNAs (miRNAs) and their role in various biological processes, such as proliferation, apoptosis, angiogenesis, metastasis, epithelial-mesenchymal transition (EMT), and treatment, as well as the potential clinical application of miRNAs as indicators for diagnosing and monitoring treatment approaches for bladder cancer (BC). We searched the studies in English conducted on animal/cell line/human specimens from the PubMed and Google Scholar databases up to 2024. Bladder cancer is one of the most common genitourinary malignancies. Early detection of cancer is vital for improving BC prognosis. There is no doubt that miRNAs are essential for the growth and function of many types of cells. They can modulate various biological processes and influence the pathological phenotypes, including bladder carcinoma. Abnormal synthesis or dysregulated signaling pathways related to miRNAs may be a significant mechanism and a compelling explanation for their aberrant expression and function in bladder neoplasia. Aberrant expression of miRNAs is associated with tumor pathological stages and grades, survival, recurrence, angiogenesis, and metastasis. In addition, miRNA expression can lead to tumor formation or progression by altering the expression or regulation of oncogenes and tumor suppressor genes. Therefore, they will have a profound impact on bladder carcinoma progression. MiRNAs are important markers for better understanding tumor biology. Considering the multifaceted role of miRNAs in different diseases and cancers, a more accurate analysis of miRNA gene expression profiles and multiple properties of miRNAs is essential. Therefore, ongoing research and technological advances will certainly reveal the hidden secrets of this process.