Cylindrocarpon destructans/Ilyonectria radicicola is thought to cause both rusty symptom and root-rot disease of American and Korean ginseng. Root-rot disease poses a more serious threat to ginseng roots than rusty symptoms, which we argue result from the plant defense response to pathogen attack. Therefore, strains causing rotten root are characterized as more aggressive than strains causing rusty symptoms. In this review, we describe the molecular evidence indicating that the pathogen strains are genetically polyphyletic and should be divided into several species.