MicroRNAs (miRNAs) are highly conserved short noncoding RNAs with the capacity of regulating gene expression posttranscriptionally. In this process, miRNAs partially bind complementary sites of target mRNAs. Among miRNAs, miR-493 performs important functions under diverse physiological conditions and participates in different pathogeneses, including pancreatic cancer, gastric cancer, and breast cancer. Differential expression of miR-493 plays a vital role in the generation, metastasis, and recurrence of tumors. Above all, increasing evidence indicates that miR-493 inhibits the generation and development of tumors by activating the Wnt/Β-catenin, Wnt/PCP, MEK/ERK, or PI3K/AKT signaling pathway, suggesting possibilities for miR-493 as an effective adjuvant cancer therapy. In this review, we discuss and summarize the biological mechanisms of miR-493 and its potential in cancer therapy. This review may provide a better understanding of the biological functions of miR-493 in tumors and provide important clues to cancer treatment.