•ZD promotes carcinogenesis in multiple pathways, such as inflammation, DNA repair, metabolic profile, and miRNA profile•Summarizing 5 miRNAs changed in ZD and their effects on carcinogenesis in the specific cancer type.•ZD can downregulate MiR-128 and miR-143 in ESCC, and overexpress MiR-31, miR-182 and miR-21 in different cancer separately. Zinc (Zn) is the second most abundant necessary trace element in the human body. It is reported that zinc deficiency (ZD) promotes many types of cancer progression through multiple signal pathways. It is well known that oxidative stress, DNA damage, DNA repair, cell cycle, cell apoptosis, metabolic alterations, microRNAs abnormal expression, and inflammation level are closely related to cancer development. Cumulative evidence suggests that ZD influences these biological functions. This review explores the latest advances in understanding the role of ZD in tumorigenesis. Fully comprehending the potential mechanisms of ZD-induced tumors may provide novel clues for prevention and clinical treatment of cancers.