A study of the components of Paris quadrifolia was undertaken to identify compounds with potential influence on cardiac cells, since previous reports suggested a cardiotoxic risk of this plant. Compounds isolated and identified included one new steroidal saponin, (23S,24S)-spirosta-5,25(27)-diene-1beta,3beta,21,23,24-pentol-1-O-beta-D-apiofuranosyl-(1-->3)-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-xylopyranosyl-(1-->3)]-beta-D-glucopyranoside 21-O-beta-D-apiofuranoside 24-O-beta-D-fucopyranoside (1), demonstrating quite unusual structural features, as well as the known compounds 26-O-beta-D-glucopyranosyl-(25R)-5-en-furost-3beta,17alpha,22alpha,26-tetraol-3-O-alpha-L-rhamnopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->4)-[alpha-L-rhamnopyranosyl--(1-->2)]-beta-D-glucopyranoside (2), pennogenin 3-O-alpha-L-rhamnopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->4)-[alpha-L-rhamnopyranosyl-(1-->2)]-beta-D-glucopyranoside (3), 7-O-beta-D-glucopyranosyl-kaempferol-3-O-beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranoside (4), kaempferol-3-O-beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranoside (5), 5-hydroxyecdysterone (6), and 20-hydroxyecdysone (7). The pennogenin derivative 3 showed strong cardiotoxic effects in an in vitro cellular model system, whereas the respective furostanol derivative 2 was inactive.