The gut microbiome, a complex community of microbes including bacteria, fungi, viruses, and protozoa, plays a crucial role in maintaining host health. Imbalances in the gut microbiome have been linked to various chronic diseases, including cardiovascular disease (CVD). Recent studies highlight the significant role of intestinal microbes in the development of CVD, which remains the leading cause of death globally. Factors such as diet, lifestyle, and genetics influence the gut microbiome, which in turn affects CVD risk factors like heart failure, hypertension, and atherosclerosis. The gut microbiota produces bioactive metabolites such as trimethylamine (TMA), trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, which have a substantial impact on host health and disease. This review compiles current evidence on the intricate links between gut microbiota, metabolites, and CVD development. It focuses on how intestinal dysbiosis promotes CVD risk factors and explores potential therapeutic interventions, including dietary changes, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation. The review also discusses the significance of gut bacteria in disease treatment and their potential as targets for CVD intervention. The gut microbiome's role in CVD is increasingly recognized, with a growing body of evidence suggesting that modulating the gut microbiota could be beneficial in preventing and managing CVD. The review highlights the importance of understanding the gut microbiome's impact on CVD and its potential as a therapeutic target.The gut microbiome, a complex community of microbes including bacteria, fungi, viruses, and protozoa, plays a crucial role in maintaining host health. Imbalances in the gut microbiome have been linked to various chronic diseases, including cardiovascular disease (CVD). Recent studies highlight the significant role of intestinal microbes in the development of CVD, which remains the leading cause of death globally. Factors such as diet, lifestyle, and genetics influence the gut microbiome, which in turn affects CVD risk factors like heart failure, hypertension, and atherosclerosis. The gut microbiota produces bioactive metabolites such as trimethylamine (TMA), trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, which have a substantial impact on host health and disease. This review compiles current evidence on the intricate links between gut microbiota, metabolites, and CVD development. It focuses on how intestinal dysbiosis promotes CVD risk factors and explores potential therapeutic interventions, including dietary changes, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation. The review also discusses the significance of gut bacteria in disease treatment and their potential as targets for CVD intervention. The gut microbiome's role in CVD is increasingly recognized, with a growing body of evidence suggesting that modulating the gut microbiota could be beneficial in preventing and managing CVD. The review highlights the importance of understanding the gut microbiome's impact on CVD and its potential as a therapeutic target.