Leukemia covers a broad category of cancer malignancies that specifically affect bone marrow and blood cells. While different kinds of leukemia have been identified, effective treatments are still lacking for most forms, and even those treatments considered effective can lead to relapses. MicroRNAs, or miRNAs, are short endogenous non-coding single-stranded RNAs that help control the epigenetics of gene expression. Recently, a literature review proposed that miRNAs provided promising therapeutic targets for patients diagnosed with leukemia. Due to genetic abnormalities occurring during the maturation of white blood cells, studies commonly observed uncontrolled replication and decreased cell death, compared to healthy cells. This results in the activation of oncogenes, deactivation of tumor suppressor genes, and disruption of normal cellular functions. Although conventional cancer treatments significantly contribute to patient recovery, they can also impose many side effects. MiRNAs all significantly regulate angiogenesis, migration, apoptosis, carcinogenesis, and gene expression. Regarding chemotherapy, mounting research indicates that microRNAs may directly influence how responsive leukemia is to chemical treatments. This article reviews current studies on microRNAs, examining their influence on cancer advancement and spread, as well as their possible applications as diagnostic indicators and treatment targets in leukemia. Furthermore, we integrated the functions of microRNAs in cancer formation and progression with leukemia patient care, offering fresh insights into leukemia detection and management strategies.