Cardiovascular disease is currently the leading cause of death in the world, and although great progress has been made in the research and clinical treatment of its pathogenesis, the mortality rate is still high, and new ways of scientific intervention are urgently needed. Intestinal flora is the most numerous and complex microbial community in the human body, which plays an important role in the healthy homeostasis of the body, and its imbalance can lead to a variety of chronic diseases including cardiovascular disease, and form a “microbiome-gut-heart axis” relationship, which speculates that intestinal flora and its metabolites may be potential biological targets for the treatment of cardiovascular disease. This article focuses on the regulatory mechanism between the “microbiome-gut-heart axis” and cardiovascular disease, and proposes the prevention and treatment of cardiovascular diseases from the perspective of intestinal microbiota, in order to provide reference for clinical treatment.