Cockroaches have existed for 300 million years and more than 4600 extant species have been described. Throughout their evolution, cockroaches have been associated with bacteria, and today Blattabacterium species flourish within specialized bacteriocytes, recycling nitrogen from host waste products. Cockroaches can disseminate potentially pathogenic bacteria via feces and other deposits, particularly members of the family Enterobacteriaceae, but also Staphylococcus and Mycobacterium species, and thus, they should be cleared from sites where hygiene is essential, such as hospitals and kitchens. On the other hand, cockroaches also carry bacteria that may produce metabolites or proteins with potential industrial applications. For example, an antibiotic-producing Streptomyces strain was isolated from the gut of the American cockroach Periplaneta americana. Other cockroach-associated bacteria, including but not limited to Bacillus, Enterococcus, and Pseudomonas species, can also produce bioactive metabolites that may be suitable for development as pharmaceuticals or plant protection products. Enzymes that degrade industrially relevant substrates, or that convert biomasses into useful chemical precursors, are also expressed in cockroach-derived bacteria and could be deployed for use in the food/feed, paper, oil, or cosmetics industries. The analysis of cockroach gut microbiomes has revealed a number of lesser-studied bacteria that may form the basis of novel taxonomic groups. Bacteria associated with cockroaches can therefore be dangerous or useful, and this review explores the bacterial clades that may provide opportunities for biotechnological exploitation.