Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC) and is a complex, relapsing chronic gastrointestinal disease. The prevalence of IBD is increasing year by year worldwide. The exact pathogenesis of IBD remains incompletely understood. There is a strong correlation between gut microbiota dysbiosis and the occurrence and progression of IBD. The review systematically describes recent advances in understanding the role of the gut microbiota in IBD, particularly how dysbiosis contributes to pathogenesis. Synthesizes the latest research advances and challenges of gut microbiota-targeted IBD therapies. It highlights their therapeutic potential and current limitations. The literature is based on a targeted selection of high-quality sources, including clinical trials, meta-analyses, systematic reviews and regulatory documents.