Iron in the gut is like a double-edged sword. On one side, it is essential for numerous physiological processes, including oxygen transport and energy production, and is crucial for addressing conditions like anemia. However, on the other side, excess or unabsorbed iron can disrupt gut homeostasis, fuel harmful pathogens, contribute to dysbiosis, and promote gut inflammation. The challenge lies in finding a balance that ensures adequate iron absorption while minimizing its adverse effects on the gut microbiota. Host and microbiota in the gut have evolved sophisticated strategies to maintain iron homeostasis within the bacterial community and balance iron needs between host and gut microbiota. Disruption of this balance by excess iron could lead to serious consequences by promoting intestinal inflammation and disease progression. Current research points to promising therapeutical approaches that enhance iron absorption while suppressing iron-induced adverse effects, such as oxidative stress and dysbiosis, in the gut. These strategies offer the potential to reduce intestinal inflammation and improve gut health, paving the way for more effective therapies to mitigate disease complications.