The principal objective of this study was to use a fermentation and extrusion process in order to improve the antioxidant properties of original Sangmaksan (ES), containing maekmoondong, omija, and white ginseng. The antioxidant activities of fermented Sangmaksan prepared with different types of ginseng [white (FSW), red (FSR), and extruded white (FSE)], were investigated. The white ginseng powder was extruded at 20% moisture content and $120^{circ}C$ of the maximum process temperature at the barrel. The antioxidant properties of Sangmaksan were increased after fermentation. Interestingly, the fermented Sangmaksan containing the extruded white ginseng evidenced more potent antioxidant properties than the fermented Sangmaksan containing white ginseng. The content of total phenolic compounds, DPPH-radical scavenging activity, acidic polysaccharide, reducing power, and total anthocyanin were highest with FSR, followed by FSE, FSW and ES, respectively. Additionally, superoxide dismutase-like activity and total flavonoid contents were highest in the fermented Sangmaksan containing extruded white ginseng. In conclusion, it can be asserted that the fermentation and extrusion process utilized in this study may prove to be an effective new process for the production of high-quality Sangmaksan.