mRNA therapeutics hold great promise for disease treatment, yet a key challenge lies in achieving site-specific mRNA delivery to maximize therapeutic efficacy while minimizing off-target side effects. This viewpoint delves into multiple complementary targeting strategies to achieve precise site-specific mRNA delivery, covering topics of administration routes, passive targeting, and active targeting. It highlights the critical importance of rationally designed nanocarriers for obtaining desired therapeutic effects and accelerating the clinical translation of mRNA therapeutics.