OBJECTIVE: This article provides a systematic review of the biological characteristics, regulatory mechanisms, and roles of MicroRNA-7 (miR-7) in the nervous system, as well as explores its clinical translation potential and challenges. METHODS: A review analysis integrating the progress of basic and clinical research related to miR-7. RESULTS: Characteristics and Regulation: miR-7 is highly expressed in mammalian brain tissues, with its function finely regulated by ceRNA networks (such as ciRS-7 and lncRNA SNHG1) and epigenetic modifications, forming a multi-layer dynamic regulatory system. MECHANISMS OF ACTION: It plays multi-faceted intervention roles in protein aggregation, neuroinflammation, mitochondrial dysfunction, and tumor progression by targeting key factors such as α-synuclein, NLRP3 inflammasome, EGFR/PI3K/AKT/mTOR pathway, and mitochondrial-related proteins (e.g. VDAC1). Role in Disease: It has significant pathophysiological implications in diseases such as Parkinson's disease, Alzheimer's disease, ischemic stroke, cerebral hemorrhage, and glioblastoma. Translational Potential: Changes in miR-7 expression in bodily fluids (blood, cerebrospinal fluid) and extracellular vesicles demonstrate diagnostic and prognostic potential; delivery systems based on nanomedicine (e.g. liposomes, graphene oxide, AAV vectors) and their combination therapy strategies (e.g. in conjunction with chemotherapy and immunotherapy) enhance its brain targeting and therapeutic efficiency. CONCLUSION: miR-7 is a key regulatory molecule in brain diseases, with significant value for basic research and clinical translation. Future advancements should leverage cutting-edge technologies such as single-cell sequencing, spatial transcriptomics, and intelligent responsive nanocarriers to deepen the understanding of its regulatory networks and address challenges such as mechanism complexity, delivery system targeting, and the lack of clinical translation standards, to accelerate its transition from basic research to clinical application.