The gut microbiota that exists in the human gastrointestinal tract is incredibly important for the maintenance of general healthas it contributes to multiple aspects of host physiology. Recent research has revealed a dynamic connection between the gutmicrobiota and the central nervous system, that can infl uence neurodegenerative diseases (NDs). Indeed, imbalances in thegut microbiota, or dysbiosis, play a vital role in the pathogenesis and progression of human diseases, particularly NDs. Herbalmedicine has been used for centuries to treat human diseases, including NDs. These compounds help to relieve symptomsand delay the progression of NDs by improving intestinal barrier function, reducing neuroinfl ammation, and modulatingneurotransmitter production. Notably, herbal medicine can mitigate the progression of NDs by regulating the gut microbiota. Therefore, an in-depth understanding of the potential mechanisms by which herbal medicine regulates the gut microbiotain the treatment of NDs can help explain the pathogenesis of NDs from a novel perspective and propose novel therapeuticstrategies for NDs. In this review, we investigate the potential neuroprotective eff ects of herbal medicine, focusing on itsability to regulate the gut microbiota and restore homeostasis. We also highlight the challenges and future research prioritiesof the integration of herbal medicine and modern medicine. As the global population ages, access to this information isbecoming increasingly important for developing eff ective treatments for these diseases.