This narrative review summarizes the epidemiology, microbiology, clinical characteristics, treatment, and outcomes of infective endocarditis (IE) caused by Lactobacillus species. The study analyzed 77 studies with data from 82 patients, revealing that the median age was 56 years, with 69.6% being male. The aortic valve was the most commonly affected site, followed by the mitral valve. Common clinical presentations included fever, embolic phenomena, sepsis, and heart failure. Aminoglycosides and penicillin were the most frequently used antimicrobials for treatment. Surgery was performed in 53.7% of patients, and overall mortality was 17.1%. Prosthetic valve IE and presentation with shock were independently associated with mortality. The study highlights the rarity of Lactobacillus IE and the challenges in diagnosing and treating it, emphasizing the need for early clinical suspicion and advanced molecular techniques for accurate identification. The review also notes the potential risks associated with probiotic use and the importance of proper antimicrobial therapy. Overall, the study provides a comprehensive overview of Lactobacillus IE, underscoring the need for further research to improve diagnostic and therapeutic strategies.This narrative review summarizes the epidemiology, microbiology, clinical characteristics, treatment, and outcomes of infective endocarditis (IE) caused by Lactobacillus species. The study analyzed 77 studies with data from 82 patients, revealing that the median age was 56 years, with 69.6% being male. The aortic valve was the most commonly affected site, followed by the mitral valve. Common clinical presentations included fever, embolic phenomena, sepsis, and heart failure. Aminoglycosides and penicillin were the most frequently used antimicrobials for treatment. Surgery was performed in 53.7% of patients, and overall mortality was 17.1%. Prosthetic valve IE and presentation with shock were independently associated with mortality. The study highlights the rarity of Lactobacillus IE and the challenges in diagnosing and treating it, emphasizing the need for early clinical suspicion and advanced molecular techniques for accurate identification. The review also notes the potential risks associated with probiotic use and the importance of proper antimicrobial therapy. Overall, the study provides a comprehensive overview of Lactobacillus IE, underscoring the need for further research to improve diagnostic and therapeutic strategies.