BACKGROUND: The gastrointestinal microbiota is vital for a well-functioning digestive tract, nutrient metabolism, immune support, and protection against pathogenic microorganisms. Disruption of this balance is known as dysbiosis. Rifaximin, an oral antibiotic with selective action, reduces harmful gut bacteria while preserving beneficial species, aiding in microbiota restoration. SUMMARY: Alterations in the intestinal microbiota are implicated in many gastrointestinal disorders. Rifaximin, by targeting and modulating the microbiota, may serve as a powerful tool in the approach of these conditions. KEY MESSAGES: This narrative review summarizes the main uses of rifaximin in gastrointestinal disorders like irritable bowel syndrome, diverticular disease, small intestinal bacterial overgrowth, traveler's diarrhea, hepatic encephalopathy, Clostridioides difficile infection, and inflammatory bowel disease.