Antimicrobial resistance (AMR) poses an immense worldwide health threat, predicted to result in as many as 10 million mortalities by 2050. With the stagnation of antibiotic discovery as well as the rapid growth of multidrug-resistant pathogens, novel therapeutic strategies are urgently required. Microbes engineered or naturally therapeutic—offer innovative approaches for targeted pathogen elimination. These include bacteriophage therapy, engineered probiotics, synthetic biology-based organisms, and microbial consortia. This review synthesizes recent advances, evaluates their clinical potential, and highlights the limitations, regulatory obstacles, and future potential for these novel therapies. Collectively, microbial-based interventions represent a promising, yet underutilized, frontier within the fight over AMR.