Ginseng and its active components, ginsenosides, have been shown to exert significant pharmacological effects on intestinal inflammation and the immune system. This review summarizes the mechanisms by which ginseng and ginsenosides regulate intestinal inflammation, modulate immune responses, promote mucosal healing, prevent colitis-associated colorectal cancer, restore gut microbiota balance, alleviate antibiotic-induced diarrhea, and relieve symptoms of irritable bowel syndrome. Ginseng and ginsenosides demonstrate strong anti-inflammatory and immunomodulatory properties, which are mediated through various pathways, including the regulation of inflammatory cytokines, modulation of immune cell function, and interaction with the gut microbiota. The review highlights the potential of ginseng and ginsenosides as promising therapeutic agents for various intestinal diseases, particularly inflammatory bowel disease (IBD), due to their ability to restore immune balance, reduce inflammation, and promote gut health. The study also discusses the molecular mechanisms underlying these effects, including the modulation of signaling pathways such as NF-κB and MAPK, and the influence on gut microbiota composition and function. Overall, ginseng and ginsenosides show great potential in the treatment of intestinal disorders through their multifaceted biological activities.Ginseng and its active components, ginsenosides, have been shown to exert significant pharmacological effects on intestinal inflammation and the immune system. This review summarizes the mechanisms by which ginseng and ginsenosides regulate intestinal inflammation, modulate immune responses, promote mucosal healing, prevent colitis-associated colorectal cancer, restore gut microbiota balance, alleviate antibiotic-induced diarrhea, and relieve symptoms of irritable bowel syndrome. Ginseng and ginsenosides demonstrate strong anti-inflammatory and immunomodulatory properties, which are mediated through various pathways, including the regulation of inflammatory cytokines, modulation of immune cell function, and interaction with the gut microbiota. The review highlights the potential of ginseng and ginsenosides as promising therapeutic agents for various intestinal diseases, particularly inflammatory bowel disease (IBD), due to their ability to restore immune balance, reduce inflammation, and promote gut health. The study also discusses the molecular mechanisms underlying these effects, including the modulation of signaling pathways such as NF-κB and MAPK, and the influence on gut microbiota composition and function. Overall, ginseng and ginsenosides show great potential in the treatment of intestinal disorders through their multifaceted biological activities.