Alcohol use disorder (AUD) is a major cause of liver damage and death, with limited pharmacological treatment options. Chronic alcohol consumption disrupts the gut microbiome, leading to dysbiosis and bacterial overgrowth, which may contribute to alcohol-related liver disease (ALD). Fecal microbiota transplantation (FMT) has shown potential in ameliorating alcohol-induced alterations in the gut, liver, and brain, potentially altering behavior. A review of preclinical and clinical studies found that FMT can modulate the gut microbiome, reduce inflammation, and improve liver function. However, most studies are in the early stages of investigation. The gut-liver-brain axis plays a critical role in AUD, with alcohol affecting the microbiome and altering behaviors such as anxiety and depression. FMT has been shown to reduce alcohol consumption and craving in some patients, though more research is needed. Clinical trials suggest that FMT may be a safe and effective treatment for ALD, but challenges remain in defining donor selection, optimal administration routes, and validating endpoints. While FMT shows promise, further large-scale studies are needed to determine its efficacy in treating AUD and ALD. The gut microbiome's role in ALD progression is increasingly recognized, with changes in bacterial, viral, and fungal communities contributing to disease severity. Probiotics and FMT may offer therapeutic benefits, but more research is required to fully understand their mechanisms and effectiveness.Alcohol use disorder (AUD) is a major cause of liver damage and death, with limited pharmacological treatment options. Chronic alcohol consumption disrupts the gut microbiome, leading to dysbiosis and bacterial overgrowth, which may contribute to alcohol-related liver disease (ALD). Fecal microbiota transplantation (FMT) has shown potential in ameliorating alcohol-induced alterations in the gut, liver, and brain, potentially altering behavior. A review of preclinical and clinical studies found that FMT can modulate the gut microbiome, reduce inflammation, and improve liver function. However, most studies are in the early stages of investigation. The gut-liver-brain axis plays a critical role in AUD, with alcohol affecting the microbiome and altering behaviors such as anxiety and depression. FMT has been shown to reduce alcohol consumption and craving in some patients, though more research is needed. Clinical trials suggest that FMT may be a safe and effective treatment for ALD, but challenges remain in defining donor selection, optimal administration routes, and validating endpoints. While FMT shows promise, further large-scale studies are needed to determine its efficacy in treating AUD and ALD. The gut microbiome's role in ALD progression is increasingly recognized, with changes in bacterial, viral, and fungal communities contributing to disease severity. Probiotics and FMT may offer therapeutic benefits, but more research is required to fully understand their mechanisms and effectiveness.