Background/Aim: Picrasma quassioides (P. quassioides) is used in traditional Asian medicine widely for the treatment of anemopyretic cold, eczema, nausea, loss of appetite, diabetes mellitus, hypertension etc. In this study we aimed to understand the effect of P. quassioides ethanol extract on SiHa cervical cancer cell apoptosis. Materials and Methods: The P. quassioides extract-induced apoptosis was analyzed using the MTT assay, fluorescence microscopy, flow cytometry and western blotting. Results: P. quassioides extract induced cellular apoptosis by increasing the accumulation of cellular and mitochondrial reactive oxygen species (ROS) levels and inhibiting ATP synthesis. Pretreatment with N-Acetylcysteine (NAC), a classic antioxidant, decreased the intracellular ROS production and inhibited apoptosis. In addition, the P38 MAPK signaling pathway is a key in the apoptosis of SiHa cells induced by the P. quassioides extract. Conclusion: The P. quassioides extract exerts its anti-cancer properties on SiHa cells through ROS-mitochondria axis and P38 MAPK signaling. Our data provide a new insight for P. quassioides as a therapeutic strategy for cervical cancer treatment. Cervical cancer is the fourth most common cancer affecting women worldwide (1), putting a huge financial and medical burden on society, so it is necessary to work together globally to improve its treatment. At present, the methods of treating cervical cancer mainly include surgery, chemotherapy and adjuvant chemotherapy (2, 3), with certain side effects, such as loss of appetite and weight loss. Screening of natural products from plant sources, such as herb extracts, with minimal side effects that can be obtained in a cost-effective manner have received global attention for treating several types of cancers (4-6). Picrasma quassioides (P. quassioides) is a Asian traditional medicine mainly distributed in Korea and South China (7). The bark, roots, stems and leaves are traditionally used for the treatment of anemopyretic cold, sore throat, dysentery, eczema, nausea, loss of appetite, diabetes mellitus, hypertension and other conditions (8-10). Chemical investigation has shown that alkaloids, including β-carboline (11, 12), canthinone (13) and bis β-carboline alkaloids (14, 1823 This article is freely accessible online.