Osteoarthritis is the most common degenerative joint disease, and the role of gut microbiota in its pathogenesis is gaining increasing attention. The aim was to summarize current evidence on the involvement of intestinal microbiota in osteoarthritis development and to identify potential mechanisms linking the microbiome with joint structures. Object and methods of the study. A retrospective analysis of publications indexed in the PubMed, Google Scholar etc. database for 2012–2025 was performed, including clinical, experimental, and review studies. Results. It was found that intestinal dysbiosis contributes to increased gut permeability, activation of Toll-like receptors, and the development of chronic low-grade inflammation, which enhances cartilage degradation and subchondral bone remodeling. The detection of bacterial DNA in the synovial fluid of patients supports the systemic nature of these processes. Conclusion. The findings suggest that gut microbiota may represent a promising therapeutic target. Its correction through prebiotics, probiotics, or dietary interventions could become a novel approach to the prevention and treatment of osteoarthritis.