Panax quinquefolium is a perennial herb of the Araliaceae family native to North America. Its roots have been used in traditional and Chinese medicine. The aim of this study was to determine the phenolic profile of methanolic extracts of P. quinquefolium hairy roots cultivated in flasks and a bioreactor, as well as extracts from the roots of three-year-old field-grown plants. Additionally, the phenol and ginsenoside components of the tested extracts were identified by HPLC, and their antioxidant and cytotoxic properties were evaluated. The antioxidant effect was evaluated by FRAP (ferric reducing antioxidant power), and ABTS ([2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) cation scavenging tests, and their effect on the viability of the glioblastoma cell (T98G) line was measured using the 3-(4,5-dimethylthazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The LC-MS/MS analysis revealed the presence of 16 phenolic compounds identified as phenolic acids (ten compounds) or flavonoids (six compounds). The highest phenol content was observed in the transformed roots of flask-grown P. quinquefolium (1.6 mg g −1 d.w.), followed by these grown in the bioreactor (1.1 mg g −1 d.w.). However, the highest ginsenoside content was found in the roots of the naturally-cultivated plants (67.6 mg g −1 d.w.). The methanolic extracts from hairy root culture of P. quinquefolium appear to have significant antioxidant and cytotoxic potential. Such transformed American ginseng root cultures could represent a potential source of bioactive metabolites for the food or pharmaceutical industry. Key message First time phenolic compound level, antioxidant and cytotoxic properties were estimated in hairy root cultures of Panax quinquefolium cultivated in flasks and nutrient sprinkle bioreactor. Ginsenosides content was also determined.