This study was designed to evaluate the combined effects of probiotic fermentation and high-pressure extraction (HPE) on the functional properties of Codonopsis lanceolata. The ground C. lanceolata samples were anaerobically fermented with Lactobacillus acidophilus ADH, Bifidobacterium longum B6, Lactobacillus rhamnosus GG, or Lactobacillus paracasei at 37 degrees C for 10 days and subjected to 500 MPa at 50 degrees C for 30 min. The extraction yields of C. lanceolata samples were noticeably increased to 29-32% by HPE. The B. longum-fermented C. lanceolata samples extracted by high pressure (BLF-HPE) exhibited the highest antimicrobial activity (MIC < 14 mg/mL) against Listeria monocytogenes, Staphylococcus aureus, Shigella boydii, and Salmonella typhimurium. The nonfermented C. lanceolata samples extracted with high pressure (NF-HPE) had the highest total phenolic content (13.3 mg of GAE/g). The lowest effective concentrations (EC(50) and EC(0.5)) were 4.55 and 1.76 mg/mL, respectively, for NF-HPE extracts, indicating its highest antioxidant activity. The BLF-HPE and L. rhamnosus-fermented C. lanceolata samples extracted by high pressure (LRF-HPE) exhibited the highest antimutagenic activities in S. typhimurium TA 100, which were 82 and 83% inhibition, respectively. The use of probiotic fermentation and HPE can produce more biologically active compounds in C. lanceolata than the conventional solvent extraction method. The results provide pharmaceutically useful information for improving biological properties and an approach to drug discovery.