Aim Myocardial fibrosis(MF)is characterized by extracellular matrix accumulation, fibroblast activation, and transformation into myofibroblast, which is one of the features of cardiac remodeling after cardiac injury. MF includes two basic types:reactive fibrosis and repair fibrosis. Two kinds of fibrosis often coexist in the process of ventricular remodeling. MF can lead to congestive heart failure, malignant arrhythmia and sudden death, and become an important cause of sustainable development and irreversible ventricular remodeling. Some studies have shown that metabolites of intestinal flora, including trimethylamine oxide, short chain fatty acids, indole oxyl sulfate and p cresol sulfate, are involved in the process of myocardial fibrosis and play an important role in the treatment of heart failure. It is expected to become a new target for the treatment of heart failure. In this paper, the mechanism of intestinal flora metabolites in myocardial fibrosis is described, and the research progress of improving myocardial fibrosis by intervention of intestinal flora is also introduced.