Consistent root orientation is one of the important requirements of Panax notoginseng transplanting agronomy. In this paper, a Panax notoginseng orientation transplanting method based on machine vision technology and negative pressure adsorption principle was proposed. With the cut-main root of Panax notoginseng roots as the detection object, the YOLOv5s was used to establish a root feature detection model. A Panax notoginseng root orientation transplanting device was designed. The orientation control system identifies the root posture according to the detection results and controls the orientation actuator to adjust the root posture. The detection results show that the precision rate of the model was 94.2%, the recall rate was 92.0%, and the average detection precision was 94.9%. The Box-Behnken experiments were performed to investigate the effects of suction plate rotation speed, servo rotation speed and the angle between the camera and the orientation actuator(ACOA) on the orientation qualification rate and root drop rate. Response surface method and objective optimisation algorithm were used to analyse the experimental results. The optimal working parameters were suction plate rotation speed of 5.73 r/min, servo rotation speed of 0.86 r/s and ACOA of 35°. Under this condition, the orientation qualification rate and root drop rate of the actual experiment were 89.87% and 6.57%, respectively, which met the requirements of orientation transplanting for Panax notoginseng roots. The research method of this paper is helpful to solve the problem of orientation transplanting of other root crops.