Ginger is a widely consumed spice and possesses numerous pharmacological properties. However, studies addressing the efficacy of ginger in humans have been inconsistent. Many confounding factors need to be considered when evaluating the health effects from ginger against chronic diseases, especially the levels of bioactive components in the ginger formulations used in human trials. Gingerols, the major compounds in fresh ginger, are liable to dehydrate and convert to shogaols, the major compounds in dried ginger, as a result of the instability of β-hydroxyl ketone when exposed to heat and/or acidic conditions. As a result of various heating and processing methods, the concentrations of gingerols and shogaols in ginger products vary significantly. Increasing evidence has shown that gingerols and shogaols have different bioactivities, molecular targets, and metabolic pathways, suggesting the importance of identifying the optimal oral ginger composition for a specific disease. In this perspective, we highlighted differences in the composition between fresh ginger and dry ginger, bioactivities, molecular targets, and metabolic pathways of gingerols and shogaols as well as future perspectives regarding precision research on ginger.