This article reviews the potential of fecal microbiota transplantation (FMT) in treating alcohol-associated liver disease (ALD) and alcohol use disorder (AUD). Chronic alcohol consumption leads to liver damage and death, and the gut microbiota plays a significant role in this process. Alcohol alters the gut microbiome, leading to bacterial overgrowth and dysbiosis, which can contribute to increased alcohol consumption and the progression of ALD. FMT has shown promise in ameliorating these effects, both in preclinical studies and some clinical trials. Preclinical studies have demonstrated that FMT can prevent the development of ALD by restoring the gut microbiome to a more balanced state. For example, FMT from ALD-resistant mice protected susceptible mice from alcohol-induced liver damage. Additionally, dietary supplements like ursolic acid and Goji berries have been shown to have hepatoprotective effects, and FMT has been used to demonstrate the transferability of these benefits. Clinical studies have also explored the effects of FMT on AUD. FMT has been found to reduce alcohol consumption and craving, improve cognitive function, and increase microbial diversity in patients with AUD. One study showed that FMT was associated with reduced alcohol relapse rates and longer time to relapse compared to standard care. The gut-brain axis, which involves communication between the gut and the brain, is another area of interest. FMT has been shown to improve cognitive performance and reduce hepatic encephalopathy in patients with cirrhosis. Cross-species studies have also demonstrated that the gut microbiota from heavy drinkers can transmit behavioral phenotypes similar to those seen in human drinkers. Despite the promising results, the body of evidence on FMT is still limited. Future research should focus on larger, prospective clinical trials to better understand the role of the gut microbiome in AUD and ALD, and to explore the potential of FMT as a therapeutic intervention.This article reviews the potential of fecal microbiota transplantation (FMT) in treating alcohol-associated liver disease (ALD) and alcohol use disorder (AUD). Chronic alcohol consumption leads to liver damage and death, and the gut microbiota plays a significant role in this process. Alcohol alters the gut microbiome, leading to bacterial overgrowth and dysbiosis, which can contribute to increased alcohol consumption and the progression of ALD. FMT has shown promise in ameliorating these effects, both in preclinical studies and some clinical trials. Preclinical studies have demonstrated that FMT can prevent the development of ALD by restoring the gut microbiome to a more balanced state. For example, FMT from ALD-resistant mice protected susceptible mice from alcohol-induced liver damage. Additionally, dietary supplements like ursolic acid and Goji berries have been shown to have hepatoprotective effects, and FMT has been used to demonstrate the transferability of these benefits. Clinical studies have also explored the effects of FMT on AUD. FMT has been found to reduce alcohol consumption and craving, improve cognitive function, and increase microbial diversity in patients with AUD. One study showed that FMT was associated with reduced alcohol relapse rates and longer time to relapse compared to standard care. The gut-brain axis, which involves communication between the gut and the brain, is another area of interest. FMT has been shown to improve cognitive performance and reduce hepatic encephalopathy in patients with cirrhosis. Cross-species studies have also demonstrated that the gut microbiota from heavy drinkers can transmit behavioral phenotypes similar to those seen in human drinkers. Despite the promising results, the body of evidence on FMT is still limited. Future research should focus on larger, prospective clinical trials to better understand the role of the gut microbiome in AUD and ALD, and to explore the potential of FMT as a therapeutic intervention.