Previous investigations link fine motor skills (FMS) with language development. Studies also examined relations between motor actions and gestures, as well as between gestures and language. However, little research has systematically investigated fine motor skills, manual gestures, and language within the same study or investigated their unique associations. In this study, we examined FMS, receptive and expressive vocabulary, narrative skills, and gesture production, imitation, and use during storytelling in 130 children (aged 3–6). FMS significantly predicted receptive vocabulary and narrative skills but not expressive vocabulary. Including manual gestures in hierarchical linear regressions reduced the association between FMS and receptive vocabulary as well as narrative skills. Notably, greater gesture use during the narrative task negatively predicted receptive vocabulary and narrative skills. Mediation analyses revealed that gesture use significantly mediated the link between FMS and both receptive vocabulary and narrative skills, indicating that gestures partially explain how FMS relate to these language outcomes. The study discusses limitations, future research needs, and educational implications.