Abstract：Stroke is a common cerebrovascular disease characterized by high incidence，disability，and mortality rates. Recent advancements in the microbiota-gut-brain axis theory have revealed complex interactions between the gut and the brain，thus providing a novel approach for stroke treatment. According to sweat pore theory，disorder of gut microbiota in stroke is a key pathogenic factor contributing to the accumulation of dampness，heat，phlegm，and blood stasis. The intestinal barrier and blood-brain barrier are considered the microscopic morphological foundations of sweat pores. The primary pathogenesis of post-stroke neurological dysfunction and cognitive impairment lies in stagnation and obstruction of sweat pores，which prevents qi-fluid from free flow and deactivation of the vital activity. The therapeutic strategies focus on opening the sweat pores， dredging qi-fluid， and activating the vital activity， thus providing a holistic approach for stroke. Exploration on the traditional Chinese medicine connotation of microbiota-gut-brain axis in stroke under the guidance of sweat pore theory not only advances the theoretical framework of sweat pores but also inspires innovative clinical interventions of stroke.