Display omitted •Beer can serve as medium for live microbe and probiotic delivery.•Sustained live cell count throughout beer shelf-life is a challenge.•Probiotic beer can be made with probiotic yeasts, bacteria or both.•Mixed-species communities are not fully explored in beer. There is growing interest in the potential of probiotics and other commensal dietary microbes to improve human health. This review will examine beer as a microbe-containing food and the considerations needed when using beer for probiotic and other live microbe delivery to the digestive tract. Although most beers harbor low numbers of live microbes after brewing is complete and the final product is an environmentally stressful environment which impairs long-term microbial survival, commercially-produced Lambic and sour beers can contain live microbes. Recent studies have also tested the viability and impacts of probiotic strains of Saccharomyces and lactobacilli strains in beer. The findings show there remains the need to adjust strain use and production practices to enable microbial growth and survival throughout the intended shelf-life. We discuss opportunities to increase microbial survival overall, as well as for strains that confer specific health benefits.