Abstract: Ellagic acid(EA) is a natural antioxidant polyphenolic acid with pharmacological effects such as anti-inflammatory, antibacterial, and anti-tumor. However, how to improve its bioavailability has always been a concern in the medical and pharmaceutical community. In recent years, it has been found that gut microbiota can participate in the metabolism of EA through multiple pathways and alter its efficacy. Research has shown that the gut microbiota in the human body interacts with EA. On the one hand, the gut microbiota biotransforms the chemical structure of EA, producing a new metabolite, urolithin; on the other hand, the utilization of EA in the gastrointestinal tract is relatively low, but some of it is metabolized by intestinal microorganisms into urolithin products to improve bioavailability. This article summarizes the latest research progress on the interaction between gut microbiota and EA components, introduces the transformation types and metabolic characteristics of natural EA under the action of gut microbiota, and elaborates on the regulatory effect of EA on gut microbiota; In addition, this article elaborates on the various pharmacological activities of EA and urolithin under the influence of gut microbiota, providing effective scientific references for further research on how to improve the bioavailability of EA, as well as the in vivo metabolic characteristics and pharmacological mechanisms of other polyphenolic natural products such as EA and urolithin.