Fermentation is an ancient preservation technique that has been used for thousands of years to preserve foods, improve sensory characteristics, and enhance nutritional quality. In recent years, scientific attention has shifted toward understanding the role of fermented foods in shaping the composition and functioning of the human gut microbiome. The gut microbiome consists of trillions of microorganisms that influence digestion, immune regulation, metabolism, neurological function, and overall health. Fermented foods provide beneficial microorganisms, bioactive compounds, and metabolites that may contribute to maintaining microbial diversity and intestinal homeostasis. This review discusses the principles of food fermentation, the composition and function of the human microbiome, mechanisms through which fermented foods influence gut microbial ecology, and current evidence regarding their health benefits. Understanding the interaction between fermented foods and the human microbiome has significant implications for disease prevention, nutritional recommendations, and the development of functional foods.