Sepsis-associated intestinal dysfunction (SAID) drives multiorgan failure through dysregulated autophagy-inflammation crosstalk, for which effective therapies remain limited. This review systematically delineates SAID pathophysiology, evaluates preclinical and clinical evidence for autophagy-targeted interventions, and explores emerging intestinal-specific therapeutic targets. Autophagy preserves intestinal barrier integrity by clearing damaged organelles and suppressing NLRP3 inflammasome activ