In 2010, she emailed Epstein saying, "I am at your service. Just marry me". In 2011, it was reported that Epstein had helped Ferguson avoid bankruptcy by paying £15,000 to an employee to whom she owed money. Ferguson had contacted Epstein in April 2011, despite her public statement in March 2011 that she had severed all ties with him. In the email, she wrote that Epstein was a "steadfast, generous and supreme friend" and said she must "humbly apologise" for her earlier remarks. Leaked emails between Epstein and his lawyer in 2011 suggesting that Ferguson had celebrated Epstein's release from jail in 2009 by visiting him in New York, where she had taken her young daughters with her.

In 2011, she admitted getting money from Epstein and called it a "gigantic error of judgment".

In October 2025, Ferguson ceased using the courtesy title Duchess of York following Andrew's announcement that he would no longer use his peerage titles.