Recent research has highlighted the potential of Codonopsis Radix to modulate the immune system, making it a promising candidate for treating chronic inflammatory and cardiovascular diseases, tumors, and aging. However, because of the complex immune activities of its various components, a comprehensive understanding of Codonopsis Radix immune-regulating properties is still lacking. This knowledge gap hinders its widespread utilization in clinical practice. Therefore, this review aimed to assess the impact of Codonopsis Radix on the immune system and elucidate its underlying mechanisms. Additionally, we compared the immunomodulatory effects of different active ingredients derived from Codonopsis Radix to provide a theoretical basis for future investigations on immunomodulation.