In this epidemiologic study, 16 S rRNA sequencing was used to investigate the changes of diversity and composition profile of gut microbiota resulting from long-term exposure to multiple metals, including arsenic (As), cadmium (Cd), cuprum (Cu), lead (Pb), and zinc (Zn). Due to long-term exposure to various metals, the relative abundances of Lachnospiraceae, Eubacterium eligens, Ruminococcaceae UGG-014, Erysipelotrichaceae UCG-003, Tyzzerella 3, Bacteroides, Slackia, italics, and Roseburia were found to become much higher, whereas the abundance of Prevotella 9 presented an opposite trend. Additionally, differences between males and female groups were found, such as the greater richness and evenness of bacteria for men subjected to long-term metal exposure in polluted areas. The changes of men's microbiomes were more significant as a result of higher daily intake, mining and smelting activity, and living habits. This research presents a new theoretical basis for the correlation between long-term metal exposure and gut health for people living in contaminated areas. Recently, the entire gut microecosystem has begun to be regarded as an essential organ in the human body 1. The intestinal microbiome plays an important role, and the microorganisms contained in the microbiome are vast in number, consisting of populations of up to 100 trillion 2. The intestinal microbiome has been proven to be profoundly responsible for maintaining human health, such as energy metabolism, environmental adaptation, immune adjustment, and even brain functions 3-5. In addition, some related metabolic diseases (obesity, cirrhosis, hypertension, etc.) have been associated with the changed structure of the microbiome 6-8. The daily diet is the most critical factor in maintaining the symbiotic relationship between intestinal flora and the host throughout the host's life 9. An epidemiologic study has confirmed that gut microbiota can respond to various dietary styles. Rural children who consumed low-sugar, high-fiber diets were found to have higher microbial richness and biodiversity compared with European children 10. Healey et al. have also found inter-individual variability in gut microbiota response to dietary interventions 11. Some other influencing factors include age, sex, and exercise, as well as prebiotic and probiotic agents 12-14. 16 S ribosomal RNA (rRNA) gene sequence analysis has been widely used to identify bacterial species and perform taxonomy, and massively parallel sequencing (MPS) is also commonly utilized 15. There are nine "hypervariable regions" (V1-V9) in the sequence that can show considerable sequence diversity and are regarded as diagnostic assays for different bacteria 16. Dethlefsen et al. 17 determined the pervasive effects of antibiotics on gut microbiota by tag pyrosequencing of the 16 S rRNA V3 region. By pyrosequencing over 40,000 16 S rRNA gene V4 region amplicons per subject, links between health conditions and intestinal microbiota in elderly Irish subjects were reported 18. Additionally, the V3-V4 regions o...