The global prevalence of obesity and related comorbidities has increased considerably over the past decades. In addition to an increase in food consumption and a reduction in physical activity, growing evidence implicates the microorganisms in our gastrointestinal tract, referred to as the gut microbiota, in obesity and related metabolic disturbances. The composition of the gut microbiota can fluctuate markedly within an individual and between individuals. Changes in gut microbial composition may be unfavorable and predispose an individual to disease. Studies in mice that are germ free, mice that are cohoused, and mice that are treated with antibiotics have provided some evidence that changes in gut microbiota may causally contribute to metabolic disorders. Several mechanisms have been proposed and explored that may mediate the effects of the gut microbiota on metabolic disorders. In this review, we carefully analyze the literature on the connection between the gut microbiota and metabolic health, with a focus on studies demonstrating a causal relation and clarifying potential underlying mechanisms. Despite a growing appreciation for a role of the gut microbiota in metabolic health, more experimental evidence is needed to substantiate a cause-and-effect relationship. If a clear causal relationship between the gut microbiota and metabolic health can be established, dietary interventions can be targeted toward improving gut microbial composition in the prevention and perhaps even the treatment of metabolic diseases.—Janssen, A. W. F., Kersten, S. The role of the gut microbiota in metabolic health.