<p>Aquaculture plays an important role in the global food economy by contributing more than half of the global demand for seafood. However, intensive aquaculture systems induce stress in cultured animals, reducing immunity and increasing disease susceptibility. The widespread use of antibiotics to prevent these diseases has led to the development of pathogen-resistant strains, indicating their unsustainability. Therefore, researchers have emphasized the use of herbal plants as feed additives that may reduce reliance on the subtherapeutic use of antibiotics, as they are inexpensive, sustainable, eco-friendly, and effective. This review summarizes the use of ginger as a feed additive in fish and shrimp in various forms, including extract, powder, and essential oil (EO). This article highlights the phytochemical composition of ginger, emphasizing its richness of phenolics, terpenoids, and flavonoids. Differences in the phytochemical profiles of extracts, powders, and EOs may influence their functional properties. Overall, ginger has beneficial effects on immune parameters, blood characteristics, and antioxidant activity in fish and shrimp depending on the dose and formulation. However, its effects on fish growth appear to vary depending on the supplementation form used. Moreover, it exhibits antimicrobial and antiparasitic activities, suggesting its potential to support disease management. Furthermore, blending ginger extract with other plant extracts produces more pronounced effects on the physiological status of fish. The form of ginger plays a critical role, as ginger extract exhibits greater beneficial effects compared to ginger powder, whereas ginger EO may exert cytotoxic effects at certain doses. Therefore, the use of ginger, particularly in extract form, should be encouraged in the aquaculture industry to improve the health of organisms. However, limited data are available on morphological and toxicological evaluations of ginger, so further research is required to ensure its safe application.</p>