<p>Cancer therapy and imaging remain multifaceted global health challenges for patients, investigators, and medical practitioners. RNA-based therapies, facilitated by nanotechnology, show great potential for targeted treatment due to their high specificity and adaptability. Chitosan nanoparticles (CS-NPs) are preferred over other polysaccharide-based nanocarriers due to their biocompatibility, biodegradability, stability, excellent gene loading capacity, and tunable physicochemical properties, which enable their modification for the co-delivery of therapeutic agents and imaging reagents. Chitosan polymer alterations occur specifically by covalent and non-covalent conjugations. Carbon dots (CDs) have been identified as nanofluorescent probes for cellular and molecular imaging due to their small size and excellent photoluminescent properties. This review proposes the recent advancements in combining RNA molecules and CDs in conjugates with chitosan nanocarriers. These nanoplatforms have shown great promise in addressing the most challenging issues encountered in cancer treatment, including targeted delivery, sustained release, protection against enzymatic degradation, and real-time tracking. Evaluating these integrated systems at an optimal level enhances the therapeutic effect and diagnostic accuracy, creating promising theranostic approaches for oncology. This paper summarizes recent research activities and upcoming trends to illustrate their potential to propel further advancements in cancer treatment nanomedicines.</p> Graphical Abstract <p></p>