This study aimed to evaluate the effects of banana (Musa paradisiaca) midrib extract supplementation as preventive and curative treatments of motile aeromonad septicemia (MAS) on giant gourami (Osphronemus gouramy). Disc diffusion assay was conducted to evaluate antibacterial activity of banana midrib extract against Aeromonas hydrophila. The most effective dose was used for subsequent tests. Experimental fish were categorized into five groups: negative control; positive control; and preventive, curative, and controlling treatments. Except negative control, all groups were challenged by A. hydrophila at a density of 107 CFU mL−1 (0.1 mL per fish). Preventive, curative, and controlling treatment groups were administered the banana midrib extract-enriched diet (3%), whereas positive and negative controls were not treated with banana midrib extract. The results showed that banana midrib extract inhibited A. hydrophila activity in giant gourami, demonstrated by lower A. hydrophila numbers in preventive, curative, and controlling treatments than those in the positive control. After the challenge test in the fish treated with banana midrib extract, immunity parameters were better than those of the positive control. Banana midrib extract was highly effective as a curative agent against MAS in giant gourami based on the highest survival of the experimental fish compared with other treatments.