Abstract： Skeletal diseases seriously affect the health and quality of life of patients. More and more studies have found that intestinal flora is closely related to skeletal diseases of kidney deficiency type，and the intestinal flora- gut- brain axis is probably a key link in the occurrence and development of various skeletal diseases of kidney deficiency type. The author comprehensively summarizes the role of intestinal flora in the pathogenesis of various skeletal diseases of kidney deficiency type including osteoporosis，knee osteoarthritis and osteonecrosis of the femoral head，as well as reviews the action mechanism of intestinal flora-gut-brain axis in regulating skeletal diseases of kidney deficiency type from short-chain fatty acids， serotonin， inflammatory cells and the related immune factors， so as to provide a new idea for the diagnosis and treatment of skeletal disease of kidney deficiency type.