Cardiovascular disease (CVD) is a kind of disease that poses a great threat to human health. Its occurrence and development are often influenced by many factors of heredity and environment. The gut bacteria are the largest population of bacteria in the human body, affecting the physiological metabolism of the host. In recent years, the interaction between intestinal flora and host has been paid more and more attention. Intestinal microflora plays an important role in human health and disease. Many studies have confirmed that intestinal flora and its metabolites can affect CVD from dyslipidemia, type 2 diabetes mellitus, hypertension, atherosclerosis, heart failure and other aspects. Therefore, it is worth exploring the scheme of using intestinal flora as the target of CVD treatment. This article will systematically review the role of gut bacteria in the pathogenesis of CVD and the methods of regulating gut bacteria to treat CVD.