Root rot caused by Cylindrocarpon destructans is one of the most important diseases of ginseng (Panax ginseng C. A. Meyer). Two types of symptoms found in ginseng root rot are black root rot and rusty root (rusty spots), in which disease severities are high and low, respectively. Symptom development and related histopathological changes were examined in an inoculation test on 2-year-old ginseng roots using virulent (Cy9801) and avirulent (Cy0001) isolates of C. destructans under different temperature conditions (13, 18, 23, and 28oC). Black root rot was only induced by Cy9801 in the lower temperature range (13, 18, and 23oC) and not at the higher temperature (28oC). No black root rot, but only rusty spot symptoms, were induced by Cy0001 at all temperatures tested except 13oC, at which no symptoms occurred on over half of inoculation sites, suggesting disease development was influenced by pathogen virulence and temperature. Wound periderms were formed in all root tissues with rust spot symptoms at 28oC caused by Cy9801 and at 18, 23, and 28oC temperatures caused by Cy0001. No wound periderm was formed at 13oC by either Cy9801 or Cy0001. Light microscopy revealed that the wound periderm was formed by initial cell divisions in cell wall formation and/or additional cell wall layering in parenchyma cells without obvious nuclear division, followed by layering of the divided cells adjacent to the inoculation sites, blocking the spread of the rot. These results suggest that disease development declined at lower temperatures and by the formation of a wound periderm at higher temperatures, and that ginseng rusty root may develop under conditions unfavorable for further disease development of C. destructans.