To meet societal needs, a large number of medicinal plants are cultivated artificially. However, issues such as diseases and continuous cropping obstacles (CCO) have severely impacted their quality and yield. Exploring and innovating the cultivation technology for medicinal plants is essential to meet their high demand and ensure sustainable development. The role of titanium dioxide nanoparticles (nano-TiO2) in medicinal plant cultivation remains unclear. To advance the application of nanotechnology in this field, a comprehensive exploration of its potential benefits is necessary. In this study, nano-TiO2 was applied to ginseng (Panax ginseng C.A. Meyer) to acquire a holistic comprehension of its impact on ginseng growth, rhizosphere, and ginseng-used soil. Our findings reveal that nano-TiO2 significantly enhances ginseng root activity and has notable effects on antioxidant enzyme systems. The two concentrations of nano-TiO2 markedly influenced the structure and composition of microbial communities in the rhizosphere and ginseng-used soil, including key microorganisms such as Chloroflexi and Acidobacteriota, which are closely involved in soil function. Furthermore, nano-TiO2 altered the competitive and cooperative relationships within microbial networks. Nano-TiO2 application significantly increased soil organic matter (SOM) content in rhizosphere and ginseng-used soils and affected the activities of several important soil enzymes. Environmental factors, such as EC, pH, and soil nutrients, were found to be the main factors influencing the microbial community. In conclusion, our findings illuminate the complex effects of nano-TiO2 on the “plant-microbial-soil” system in the context of ginseng cultivation. This work offers novel strategies for optimizing medicinal plant growth and development, as well as improving cultivated soil by using nanomaterials.