Metabolic alterations play a key role in promoting tumor initiation and progression, leading to extensive tumor heterogeneity and adaptability. Thus, targeting abnormal metabolic processes is a promising novel approach for cancer treatment. Numerous pharmacological studies have indicated that many traditional Chinese medicines possess remarkable antitumor activities. Ginsenosides, the main bioactive ingredients of Panax and other types of ginseng, exert beneficial antitumor effects, in addition to the anti-inflammation, anti-oxidant, and anti-fatigue effects. Recently, considerable attention has been paid to the regulation of cancer cell metabolism by ginsenosides. Here, we summarize the structural characteristics and classification of ginsenosides, their antitumor mechanisms, recent progress and the achievements of ginsenoside research in modulating cancer cell metabolism, including the diverse metabolic processes and their regulatory processes, as well as the opportunities and challenges of strategies targeting metabolic vulnerabilities. This review provides novel perspectives on the potential applications of ginsenosides that exert antitumor effects by reshaping cancer metabolism.