Atherosclerosis is the main cause of most cardiovascular diseases. Given the increasing morbidity and mortality in these diseases in recent years, it is important to investigate novel treatments and preventive strategies for atherosclerosis. Tea polyphenols (TPs), natural substances derived from tea, have a variety of functions such as anti-inflammation and antioxidants. Numerous studies have closely linked TPs and gut microbiota to the development of atherosclerosis. By retrieving EBSCO, PubMed, Wiley InterScience, and Google Scholar databases, our review selects relevant literature from 1998 to 2023 to summarize the mutual interaction between TPs and gut microbiota and their protective effect on atherosclerosis. Specifically, TPs influence the diversity and abundance of gut microbiota, which may relieve atherosclerosis by promoting the colonization of beneficial microbiota and inhibiting the colonization of harmful microbiota. Simultaneously, the involvement of gut microbiota in TPs metabolism not only increases the bioavailability of TPs but also generates active metabolites, like gallic acid and protocatechuic acid, which have been found to alleviate atherosclerosis. Furthermore, the review outlines recent advances and challenges in the utilization of gut microbes and TPs for the prevention and treatment of atherosclerosis. In general, the review reflects the great potential of the interaction between TPs and gut microbes in the prevention and treatment of atherosclerosis.