Cardiovascular diseases (CVDs) remain one of the leading causes of death worldwide, imposing a significant societal burden and highlighting the urgent need for effective disease management strategies to reduce mortality and prevent disability. Recently, gut microbiota and its metabolites have been considered as an essential part of human physiology, emphasizing their contributions in CVD development and management. An increasing number of studies have shown that gut microbiota affects the process of CVDs either directly through changes in its composition and function or indirectly through its metabolites, and plays an important role in host physiology and disease development. This review provides a comprehensive overview of how gut microbes and their specific metabolites interact and contribute to the generation and development of CVDs. In addition, the therapeutic potential to treat CVDs by targeting the gut microbiota is also discussed, which may provide promising possibilities for the clinical treatment of CVDs in the future.