Cyclic adenosine monophosphate (cAMP) plays a key role in signal transduction pathways as a second messenger. cAMP can regulate the transcription of various target genes, mainly through protein kinase A (PKA) and its downstream effectors such as cAMP-responsive element binding protein (CREB). In addition, PKA can phosphorylate many kinases such as Raf, GSK3 and FAK. Aberrant cAMP-PKA signaling is involved in various types of diseases, such as prefrontal cortex disorders, chronic inflammatory diseases, chronic lymphocytic leukemia (CLL) and human tumors. Especially, cAMP signaling may have both tumor-suppressive and tumor-promoting roles depending on the tumor types and context. cAMP-PKA signaling can regulate cancer cell growth, migration, invasion and metabolism.