Esophageal tumor (ET) is aggressive and has poor prognosis. Although the incidence of ET has been reduced by the changing tumor profile, the 5-year survival and mortality rate of ET has not significantly changed, and the outlook has remained bleak. Therefore, new molecular markers for early diagnosis and prognosis judgment are urgently required. In recent years, tumor has been widely regarded as genetic disease along with epigenetic abnormalities. DNA methylation, histone deacetylation, chromatin remodeling, gene imprinting, and noncoding RNA regulation are the major parts of epigenetic regulation. Mounting evidence exists that miRNAs (microRNA), a class of small, endogenous, and non-protein-coding RNAs, provide a novel tool for early clinical diagnosis, prognosis judgment, and gene therapy of ET. In this review, we provide a general overview of the connection between miRNA profiles and their target genes. We also describe in detail in ET from the aspect of clinical insights, the potential application of miRNAs as biomarkers, potential diagnostic and therapeutic tools.