〔Abstract〕 Abstract Cholestasis can be seen in many acute and chronic liver diseases . If not intervened in time , persistent cholestasis can further progress to liver fibrosis , liver cirrhosis , liver failure , and even death . The pathogenesis of cholestasis is complex , and there is currently a lack of effective therapeutic drugs . Bile acids ( BAs) , the main component of bile , are synthesized from cholesterol in the liver as primary bile acids . After entering the intestine through the enterohepatic circulation , they are reshaped into secondary bile acids by gut microbiota. BAs can di- rectly or indirectly affect the composition and function of gut microbiota , which in turn can regulate the synthesis and metabolism of BAs . The interaction between BAs and gut microbiota plays an important role in the pathogenesis and treatment of cholestasis . This review elucidates the bidirectional regulatory mechanisms between BAs and gut microbiota and their roles in the pathogenesis and treatment of cholestasis , aiming to provide insights and references for basic research and clinical practice related to cholestasis-associated diseases .