Background: The cultivation of ginseng (Panax ginseng C. A. Meyer) in greenhouses could reduce the use of pesticides and result in higher yield; however, construction costs are problematic. The adaptation of direct-sowing culture in greenhouses could reduce the cost of ginseng production. Methods and Results: To improve seedling establishment in direct-sowing culture, effects of sowing density (SD), number of seeds sown per hole (SN), and thinning (TH) treatment on the root yield were investigated after 3 years of seeding. The emergence rate was significantly influenced by SD, but not by SN or TH. Damping-off and rusty roots increased with an increase in SN with diminishing effects of SN on seedling establishment. Root weight and diameter were affected by SD, SN, and TH, however, there were no statistical significances. The total number of roots harvested per unit area increased with increasing SD and SN, and the weight of roots was affected by SD, but not by SN or TH. Conclusions: Multi-seed sowing per hole and/or thinning might not be an efficient method for the direct-sowing culture of ginseng. The SD for direct seeding culture in greenhouses should be approximately 33 - 42 seeds/㎡ for an optimum yield of 3-year-old ginseng.