The gut microbiota has been implicated in the multifactorial pathophysiology of cardiometabolic diseases (CMD).Bacteriophage (phage) therapy offers precise modulation of the gut microbiota, targeting specific pathobionts while minimizing collateral damage to beneficial microbes.Studies highlight the therapeutic potential of phages in cardiometabolic diseases, including reductions in pathogenic bacteria and improvements in metabolic parameters.Challenges in developing phage therapy for CMD include identifying target bacteria, generating effective combinations of phages, product formulation, and strict production requirements.Temperate phages and phages with CRISPR-Cas machinery could alter (metabolic) the function of gut microbes to improve the CMD phenotype in the future. The worldwide prevalence of cardiometabolic diseases (CMD) is increasing, and emerging evidence implicates the gut microbiota in this multifactorial disease development. Bacteriophages (phages) are viruses that selectively target a bacterial host; thus, phage therapy offers a precise means of modulating the gut microbiota, limiting collateral damage on the ecosystem. Several studies demonstrate the potential of phages in human disease, including alcoholic and steatotic liver disease. In this opinion article we discuss the potential of phage therapy as a predefined medicinal product for CMD and discuss its current challenges, including the generation of effective phage combinations, product formulation, and strict manufacturing requirements. The worldwide prevalence of cardiometabolic diseases (CMD) is increasing, and emerging evidence implicates the gut microbiota in this multifactorial disease development. Bacteriophages (phages) are viruses that selectively target a bacterial host; thus, phage therapy offers a precise means of modulating the gut microbiota, limiting collateral damage on the ecosystem. Several studies demonstrate the potential of phages in human disease, including alcoholic and steatotic liver disease. In this opinion article we discuss the potential of phage therapy as a predefined medicinal product for CMD and discuss its current challenges, including the generation of effective phage combinations, product formulation, and strict manufacturing requirements.