Abstract: MicroRNAs (miRNAs) are small, non-coding RNAs that play a crucial role in post-transcriptional gene regulation by modulating mRNA stability and translation. These evolutionarily conserved molecules undergo processing by ribonucleases Drosha and Dicer, ultimately joining the RNA-induced silencing complex to silence gene expression. Among them, miR-23a, located on chromosome 19, is significant for its roles in cell growth, differentiation, and various diseases, including cancer. Depending on the cancer type, miR-23a can function as both an oncogene and a tumour suppressor. While its overexpression often correlates with aggressive tumours, miR-23a holds promise as a biomarker for early cancer detection and a therapeutic target. Its diverse functions in cancer include promoting tumour growth and hindering immune responses, highlighting its potential for personalized medicine. Beyond cancer, miR-23a is involved in blood sugar regulation, insulin resistance, muscle atrophy, and other diseases. It modulates pathways in type 2 diabetes mellitus, muscle atrophy, leukemia, epilepsy, and osteoarthritis. This paper aims to comprehensively analyze the roles of miR-23a in cancer and other diseases, focusing on its regulatory mechanisms, target genes, and pathways. It also evaluates the potential of miR-23a as a biomarker and therapeutic target. Despite its significance, research gaps remain, particularly in understanding the interactions of miR-23a with other miRNAs and the detailed mechanisms underlying its role in various diseases. More research into miR-23a clustering and how it works with other miRNAs could help us learn more about it and find better ways to use it to diagnose and treat diseases.