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The traditional processing of red ginseng involves washing and steaming (90 to 100℃) of raw ginseng, followed by the primary drying (moisture content 35 to 40%), storage and aging, the second drying (moisture content 16%), and molding. When raw ginseng is steamed and heat-treated during red ginseng processing, chemical changes occur in the ginseng compositions to produce active substances that do not exist in raw ginseng or white ginseng. The major components that change during red ginseng processing are saponins and non-saponins (polyacetylene, acidic polysaccharides, and amino acids). The major processing steps include heat treatment and drying during the traditional and recently developed red ginseng process. Red ginseng manufacturing process could shorten when the extrusion process applied to red ginseng processing. During the extrusion process, various steps of unit process including mixing, grinding, heating, molding, and drying occurs within a short time thus, this process is effective and economical compared with other thermal processes. Aim of this study reviews recent red ginseng manufacturing process including patents and traditional process, application of extrusion-cooking to red ginseng process, and physicochemical properties of extruded red ginseng.