Fermented foods have long been celebrated for their sensory diversity and health-promoting potential. Recent advances in microbiome science and food biotechnology are unlocking new possibilities for designing next-generation fermented products that go beyond tradition to target specific health outcomes. This session explores cutting-edge strategies in microbial strain selection, precision fermentation, and functional ingredient fortification to create products that modulate gut microbiota, enhance metabolic health, and support immune function. Topics will include probiotic–prebiotic synergies, fermentation-driven bioactive synthesis, and novel substrates from plant-based and sustainable sources. By bridging traditional fermentation wisdom with omics-based microbial insights and bioprocess engineering, these innovations promise to transform the role of fermented foods from everyday nourishment to precision nutrition tools for a thriving microbiome.