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This study investigated the fermentation effect of Taraxacum platycarpum Dahlst. leaf extracts using Hericium ernaceum mycelia to test antioxidant and anti-inflammatory activities in vitro. The antioxidant activities of fermented or non-fermented extracts of T. platycarpum leaves were determined by 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity, ferric reducing antioxidant power, and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical scavenging activity. The leaf extract of T. platycarpum showed higher antioxidant activity than extract of fermented leaves. However, ethanolic extract of fermented T. platycarpum leaves decreased levels of nitric oxide production and pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α in lipopolysaccharide-stimulated RAW 264.7 cells. Moreover, fermented leaf extract suppressed protein expression of inducible nitric oxide synthase in RAW 264.7 cell culture. Therefore, the enhanced anti-inflammatory activity of ethanolic extracts of fermented T. platycarpum leaves might be attributed to the molecular conversion of leaf ingredients during fermentation and the active ingredients might have specific affinity with ethanol during extraction.