<p>The gut-brain-heart axis represents a dynamic interplay between the gut microbiota, cognitive function, and cardiovascular health, with profound implications for understanding and managing chronic diseases. In dysbiosis, a disruption in microbial balance contributes to neuro-inflammation, mood disorders, neurodegenerative diseases, and cardiovascular conditions such as atherosclerosis and hypertension. To date, researchers explored different mechanism through which gut microbial communities influence the activities of brain and heart. In order to understand these mechanisms summative, in this review, we focused on key communication pathways between microbiota-gut-brain-heart, such as vagus nerve, gut-derived metabolites, and systemic inflammation. Furthermore, the review discusses the bidirectional nature of these relationships, where cardiovascular and cognitive health mutually influence one another. Therapeutic interventions, including probiotics, dietary modifications, biotechnological approach and lifestyle changes are evaluated for their potential to modulate the gut-brain-heart axis and improve health outcomes. Despite significant advances, challenges remain in understanding the complex interactions within this axis. Future research directions emphasize personalized medicine approaches and the potential of microbiome-targeted therapies to revolutionize the prevention and treatment of cognitive and cardiovascular disorders.</p>