Rosacea is a chronic inflammatory skin disease primarily characterized by persistent facial erythema, telangiectasia, papules, and pustules. Its pathogenesis is closely associated with dysfunction of the gut-skin axis. Based on the gut-skin axis theory, this review systematically summarizes the relationship between gut dysbiosis and rosacea. Current evidence indicates that patients with rosacea exhibit characteristic alterations in gut microbiota composition, which contribute to the onset and progression of rosacea through multiple mechanisms, including the disruption of intestinal barrier integrity, induction of systemic immune dysregulation, and reduction of anti-inflammatory short-chain fatty acids (SCFAs).Furthermore,various therapeutic strategies targeting the gut-skin axis,such as probiotics/postbiotics,specific dietary interventions,and botanical extracts,have demonstrated potential efficacy in the management of rosacea.Future largescale prospective studies and multi-omics integrative analyses are warranted to establish causal relationships, thereby providing a theoretical foundation for the development of gut microbiometargeted personalized therapies for rosacea.