p-Cymene (p-C) [1-methyl-4-(1-methylethyl)-benzene] is a monoterpene found in a variety of plants and has several biological activities, including antioxidant, anti-inflammatory, antimicrobial, and anticancer properties. This paper explores the microbial fermentation pathways involved in the biosynthesis of p-C, with an emphasis on its potential as a therapeutic agent. Through microbial and biochemical processes, p-C can be produced using renewable precursors such as limonene and 1,8-cineole. Recent advances in fermentation technology have enhanced the efficiency of p-C production, highlighting its role in various industries. Additionally, this paper reviews the antimicrobial bioactivity of p-C, focusing on its ability to inhibit pathogens and modulate immune responses. The integration of microbial biosynthesis and fermentation methods offers a sustainable approach to producing p-C for applications in the perfume, cosmetics, food, and pharmaceutical sectors. Understanding these biosynthetic pathways is crucial for advancing the use of p-C as a bio-based chemical with therapeutic potential. In particular, p-C inhibits the expression of cytokine signal 3 in intestinal inflammation and modulates antioxidant and immunomodulatory systems to protect barrier cells and maintain the mucus layer.