Alzheimer's disease (AD) is a fatal neurodegenerative disorder characterized by the accumulation of amyloid plaques and neurofibrillary tangles. Despite extensive research, the exact pathophysiology of AD remains unclear. Recent studies have highlighted the role of the gut microbiome in AD, suggesting that alterations in gut microbiota composition are associated with AD progression. This review aims to summarize the current understanding of the microbiota-gut-brain axis in AD, discussing the evidence for the role of gut microbiota in AD pathogenesis, underlying mechanisms, and biological factors influencing this axis. The review also explores potential therapeutic approaches to modulate the gut microbiota to alleviate AD progression, including antibiotics, fecal microbiota transplantation (FMT), prebiotics, probiotics, and postbiotics. While these approaches show promise, more research is needed to fully understand the mechanisms and establish effective interventions. The review emphasizes the need for standardized protocols and rigorous study designs to advance the field and develop more effective treatments for AD.Alzheimer's disease (AD) is a fatal neurodegenerative disorder characterized by the accumulation of amyloid plaques and neurofibrillary tangles. Despite extensive research, the exact pathophysiology of AD remains unclear. Recent studies have highlighted the role of the gut microbiome in AD, suggesting that alterations in gut microbiota composition are associated with AD progression. This review aims to summarize the current understanding of the microbiota-gut-brain axis in AD, discussing the evidence for the role of gut microbiota in AD pathogenesis, underlying mechanisms, and biological factors influencing this axis. The review also explores potential therapeutic approaches to modulate the gut microbiota to alleviate AD progression, including antibiotics, fecal microbiota transplantation (FMT), prebiotics, probiotics, and postbiotics. While these approaches show promise, more research is needed to fully understand the mechanisms and establish effective interventions. The review emphasizes the need for standardized protocols and rigorous study designs to advance the field and develop more effective treatments for AD.