Objective:This review aimed to summarize the relationship between intestinal microbiota metabolism and cardiovascular disease (CVD) and to propose a novel CVD therapeutic target.Data Sources:This study was based on data obtained from PubMed and EMBASE up to June 30,2015.Articles were selected using the following search temps:Intestinal microbiota,trimethylamine N-oxide (TMAO),trimethylamine (TMA),cardiovascular,and atherosclerosis.Study Selection:Studies were eligible if they present information on intestinal microbiota metabolism and atherosclerosis.Studies on TMA-containing nutrients were also included.Results:A new CVD risk factor,TMAO,was recently identified.It has been observed that several TMA-containing compounds may be catabolized by specific intestinal microbiota,resulting in TMA release.TMA is subsequently converted to TMAO in the liver.Several preliminary studies have linked TMAO to CVD,particularly atherosclerosis;however,the details of this relationship remain unclear.Conclusions:Intestinal microbiota metabolism is associated with atherosclerosis and may represent a promising therapeutic target with respect to CVD management.