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Necrotizing enterocolitis (NEC) is the most severe life threatening gastrointestinal disease among preterm neonates that continues to account for substantial morbidity and mortality in neonatal intensive care units worldwide. Despite decades of research, NEC pathophysiology still remains unclear, impairing the development of novel and effective strategies for disease prevention and treatment. Nevertheless, NEC has been proposed to be a multifactorial disease that involves the intestinal microbiota. If no specific bacteria have yet been associated with this disease, epidemiological studies, clinical signs, and animal models support bacteria participation in NEC development. Therefore, we propose an update on intestinal microbiota and NEC. [ABSTRACT FROM AUTHOR]