Hypoxia, a condition of insufficient oxygen supply to the tissue, is a hallmark feature of the tumor microenvironment. It can result from inadequate oxygen supply or transport or the inability of the tissue to utilize oxygen. Cells react to hypoxia with hypoxia-inducible factors (HIF), which promote vascularization and regulate the signal cascade and related genes to facilitate cancerous cell proliferation and invasion. HIF-1α promotes the Warburg effect under hypoxic conditions. Several noncoding RNAs (ncRNAs) have emerged as key roles in hypoxia-driven cancer progression. NcRNAs consist of a large group of RNA molecules that are not translated into proteins, including transfer RNA, ribosomal RNA, small nuclear RNA, small interfering RNA, small nucleolar RNA, long noncoding RNA, piwi-interacting RNA, and Y RNA components of the Ro60 ribonucleoprotein essential for DNA replication. In the future, ncRNAs will likely help scientists and doctors find molecular markers that aid in making more precise diagnoses and distinguishing between cancerous and benign tissues. These tests will most likely be ordered to ascertain the prognosis, such as the likelihood of metastasis or response to therapies like chemotherapy. RNA-based treatments should be carefully considered compared to biologics or small molecules. RNA-based methods can effectively target various combinations of RNAs, but optimization of delivery strategies for RNA-based medications is often necessary. Unlike small molecules and biologics, RNA-based therapies are more challenging to formulate for oral administration.