It has been more than a decade since the microbiota was recognised as a key factor in the pathogenesis of several health conditions from neurological conditions to gastrointestinal conditions such as inflammatory bowel disease (IBD). Improved understanding of the human microbiota and recent technological advances have provided an opportunity to understand microbial changes more fully as well as developing a new generation of therapeutics including dietary interventions, human donor-derived faecal microbiota transplants, rationally selected combinations of bacterial strains as live biotherapeutics, and microbiome mimetics. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which will define how we approach diagnosis and treatment many conditions in the future. My talk will discuss the status of microbial understanding in health and disease as well as highlighting the current status and potential future of microbial therapeutics.