Cardiovascular diseases have become the leading cause of mortality worldwide. The gut microbiota and its metabolites play an important role in the occurrence and development of cardiovascular diseases, and an imbalance of gut microbiota and its metabolites can promote the progression of cardiovascular diseases. Phenylacetylglutamine is a phenylalanine metabolite of intestinal flora. More and more studies have shown that phenylacetylglutamine is an independent risk factor of cardiovascular diseases and a potential biomarker of cardiovascular diseases. It is involved in the pathogenesis of cardiovascular diseases, such as arrhythmia, heart failure, atherosclerosis, etc. Therefore, interventions targeting phenylacetylglutamine are expected to become a new strategy for treating cardiovascular diseases. This review focuses on the role of phenylacetylglutamine in the occurrence and development of several common cardiovascular diseases.