Objective:To observe the effects of moxibustion on bone metabolism, gut microbiota (GM), and short-chain fatty acids (SCFAs) in ovariectomy-induced osteoporosis (OP) model rats, and to explore its potential mechanisms in improving OP.Methods:Twenty-four nine?week?old female Sprague–Dawley rats were randomly divided using a random number table into a sham operation group (Sham,?n?=?8) and a surgical group (n?=?16). Rats in the surgical group underwent bilateral ovariectomy to establish an osteoporosis (OP) model. After successful modeling, they were further randomized into a model group (Model,?n?=?8) and a moxibustion group (Moxi,?n?=?8). The Moxi group received daily moxibustion at bilateral “Pishu” and “Zusanli” acupoints for 20?minutes over eight consecutive weeks, while the Sham and Model groups received no intervention.After the intervention, tibial tissues, blood samples, and intestinal contents were collected. Histological morphology of the tibia was observed by hematoxylin–eosin (HE) staining. Serum levels of bone alkaline phosphatase (BALP), osteocalcin (BGP), procollagen?I?N?terminal propeptide (PINP), and estradiol (E2) were determined by enzyme?linked immunosorbent assay (ELISA). High-throughput 16S rRNA sequencing was performed to analyze the diversity and structural changes of the gut microbiota.Liquid chromatography–mass spectrometry (LC-MS) was used for targeted quantitative analysis of SCFAs in intestinal contents.Results: Compared with the Sham group, rats in the Model group showed a significantly accelerated rate of body weight gain (P <0.001), markedly decreased serum levels of bone metabolism-related indicators (P <0.001), sparse and fractured trabeculae in the tibia, and increased fat vacuoles in the bone marrow cavity. In addition, the gut microbiota was disrupted, with an abnormally elevated Firmicutes/Bacteroidetes (F/B) ratio,significantly altered beta diversity, and an abnormal SCFAs metabolic profile. Compared with the Model group, moxibustion intervention significantly inhibited abnormal body weight gain in rats (P <0.001), markedly restored serum bone metabolism-related indicators (P <0.001), and significantly improved bone microstructure and bone marrow fat infiltration. Meanwhile, the gut microbiota structure was remodeled, the F/B ratio was significantly reduced, characteristic taxa such as Alloprevotella were enriched, SCFAs metabolic disturbances were partially reversed, and the overall metabolic profile tended to approach that of the Sham group.Conclusion:Moxibustion can improve bone microstructural damage and bone metabolism abnormalities in ovariectomy-induced OP rats, accompanied by alterations in gut microbiota structure and SCFAs metabolic profiles. These findings suggest that its bone-protective effect may be associated with the “gut-bone axis,” although the specific causal mechanisms require further experimental verification.