The contribution of gut microbiota to human health and diseases has expanded our insights into how microbial composition and function impacts the human host. Recently, several metabolites produced by gut microbes from dietary metabolism have also been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity and type 2 diabetes mellitus. These findings suggested that the gut microbiome functions like an endocrine organ by generating bioactive metabolites that can directly or indirectly impact host physiology. In this talk, I will discuss several newly discovered gut microbial communities and metabolic pathways, including the production of dietary nutrient metabolites and secondary bile acids that appear to participate in the development and progression of cardiometabolic diseases. We will also discuss the gut microbiome as a novel therapeutic target for the treatment of cardiovascular disease, and potential strategies for targeting intestinal microbial processes.