<p>Stroke is a condition characterized by high rates of morbidity, mortality, and disability. Developing new and effective treatments is critical for improving stroke rehabilitation outcomes. Microbiota-gut-brain axis has garnered significant attention as a bidirectional communication network linking gut microbiota with their host organisms. A considerable number of post-stroke patients develop gastrointestinal complications. The microbiota plays a critical role in both the development and prognosis of stroke. Ellagic acid, which possesses anti-inflammatory and antioxidant properties, may modulate the gut microbiota and thereby improve stroke outcomes. This review focuses on the intricate interplay among gut microbiota, ellagic acid, and stroke pathogenesis and recovery. We systematically analyzed the in vivo metabolism of ellagic acid, elucidating its key biological activities and therapeutic potentials. Concurrently, we pointed out its limitations such as solubility-limited bioavailability. This report highlights that ellagic acid can ameliorate stroke outcomes by modulating gut microbiota, proposes the development of advanced drug delivery systems and bioactive derivatives as promising strategies to enhance its efficacy and translational potential.</p>