A systematic review published in the European Medical Journal (EMJ) reveals a significant association between the composition of the female reproductive tract (FRT) microbiota and the risk of both sporadic and recurrent miscarriage. This emerging research underscores the potential role of microbial communities in early pregnancy outcomes, offering new perspectives for reproductive health screening and intervention strategies. Miscarriage, affecting up to 20% of recognized pregnancies, imposes substantial physical and emotional burdens, and while genetic and immunological factors are known, the role of microbiota is an evolving area of investigation. The review, which synthesized evidence from 43 studies, consistently found that a reduced abundance of protective *Lactobacillus* species, especially in the vaginal and endometrial microbiota, was associated with miscarriage events. *Lactobacillus* species are crucial for maintaining mucosal health by creating a low-pH environment that inhibits pathogenic organisms. Conversely, an imbalance, or dysbiosis, characterized by a decrease in *Lactobacillus* and an increase in other bacteria such as *Prevotella*, *Streptococcus*, *Atopobium*, and *Gardnerella*, can lead to local inflammation that may contribute to pregnancy loss. These findings have critical implications, suggesting that specific alterations in the reproductive tract microbiota could serve as targets for diagnostic tools, such as microbial profiling, and potential therapeutic strategies. Future interventions might include probiotics or *Lactobacillus crispatus* transplantation to restore a healthy microbial balance. However, the review also acknowledged inconsistencies and variability across studies, highlighting the need for future standardization in research methodologies, including sampling, sequencing, and reporting, to allow for more accurate comparisons and to confirm causality and efficacy of interventions. This research provides a crucial step towards understanding and potentially preventing miscarriage, a global health concern.