Abstract:Gut microbes, known as the body’s “second gene pool”, play a role in the treatment of osteoporosis. They affect the connection between intestinal tract and bone metabolism through intestinal epithelial barrier, immune system, endocrine system, and intestinal flora metabolites in the gut-bone axis. Novel gut microbiota-targeted therapies such as probiotics, prebiotics, and dietary supplements have been shown to be effective in preventing bone loss. However, their long-term efficacy and safety still need to be further enhanced. Therefore, this paper discusses the main role of the microbe-gut-bone axis in osteoporosis, which is expected to provide new ideas for the treatment of this disease.