Despite promising developments of treatment, the overall outcome of gastric cancer (GC) remains poor. Current tumor markers are not ideal due to relatively low sensitivity and specificity. There is an urgent need for identifying more specific and more sensitive novel markers in the clinical management of GC. MicroRNAs (miRNAs) are non-coding RNA molecules. Recently, miRNA studies have quickly moved from basic molecular research of cancer to areas of clinical application. On the basis of recent data, the present review mainly summarizes the potential role of miRNAs as molecular biomarkers for disease susceptibility, diagnosis, prognosis and drug-response prediction in GC. This review also highlights the miRNA expression profiles in GC and their relation to cancer classification and subtype stratification. Although there are still many challenges in the research field of tumor-related miRNAs, the small molecules will definitely improve the clinical management of GC in the future.