The wilt disease of ginger, caused by various Fusarium species, imperils the cultivation of this valuable crop. However, the pathogenic mechanisms and epidemiology of ginger wilt remain elusive. Here, we investigate the association between ginger rhizome health and the prevalence of Fusarium conidia, as well as examine fungal community composition in symptomatic and asymptomatic ginger tissues. Our findings show that diseased rhizomes have reduced tissue firmness, correlating negatively with Fusarium conidia counts. Pathogenicity assays confirmed that both Fusarium oxysporum and Fusarium solnai are capable of inducing wilt symptoms in rhizomes and sterile seedlings. Furthermore, Fungal community profiling revealed Fusarium to be the dominant taxon across all samples, yet its relative abundance was significantly different between symptomatic and asymptomatic tissues. Specifically, there is a higher incidence of Fusarium ASVs in symptomatic above-ground parts. Our results unequivocally implicate F. oxysporum or F. solnai as the etiological agents responsible for ginger wilt and demonstrate that Fusarium is the principal fungal pathogen associated with this disease. These findings provide critical insights for efficacious disease management practices within the ginger industry.