The gut microbiome, comprising a diverse population of microbes, plays a crucial role in maintaining host equilibrium and influencing human health. Imbalances in gut microbes are linked to various chronic diseases, including cardiovascular disease (CVD). CVD, a leading cause of mortality globally, encompasses conditions such as atherosclerosis, hypertension, and diabetes. The gut microbiota produces bioactive metabolites like trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, which significantly impact host health and disease progression. This review highlights the intricate links between gut microbiota, metabolites, and CVD, focusing on how intestinal dysbiosis promotes CVD risk factors such as heart failure, hypertension, and atherosclerosis. It explores the normal physiology of intestinal microbes and potential therapeutic interventions, including dietary changes, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation. The review also discusses the role of specific microbial metabolites, such as TMAO and SCFAs, in CVD and their therapeutic potential. Understanding the gut microbiome's impact on CVD can guide the development of novel therapeutic strategies to prevent and manage cardiovascular diseases.The gut microbiome, comprising a diverse population of microbes, plays a crucial role in maintaining host equilibrium and influencing human health. Imbalances in gut microbes are linked to various chronic diseases, including cardiovascular disease (CVD). CVD, a leading cause of mortality globally, encompasses conditions such as atherosclerosis, hypertension, and diabetes. The gut microbiota produces bioactive metabolites like trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, which significantly impact host health and disease progression. This review highlights the intricate links between gut microbiota, metabolites, and CVD, focusing on how intestinal dysbiosis promotes CVD risk factors such as heart failure, hypertension, and atherosclerosis. It explores the normal physiology of intestinal microbes and potential therapeutic interventions, including dietary changes, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation. The review also discusses the role of specific microbial metabolites, such as TMAO and SCFAs, in CVD and their therapeutic potential. Understanding the gut microbiome's impact on CVD can guide the development of novel therapeutic strategies to prevent and manage cardiovascular diseases.