Abstract: Ginseng （Panax ginseng C. A. Mey） is a traditional tonic medicine with immunoregulatory， anti-fatigue and anti-tumor efficacy. Recent studies have shown a bidirectional regulation between active ingredients in ginseng and the gut microbiota， which may shed novel insights into its mechanisms of action. This review outlines the disposition of ginsenosides and ginseng polysaccharides by the gut microbiota， and， from the perspective of gut microbiota modulation， discusses the potential mechanism in the prevention or treatment of diseases including ulcerative colitis， obesity， type 2 diabetes and ischemic stroke. The progress on the crosstalk between gut microbiota and phytochemicals is expected to deepen the mechanistic understanding of ginseng pharmacology， as well as inspiring new thoughts in the research and development of traditional Chinese medicine.