Three new pregnane alkaloids, pachystermine C (1), pachysanamine A (2), and pachysanamine B (3), together with four known ones, pachystermine B (4), pachysamine A (5), (20S)-20-(dimethylamino)-16α-hydroxy-3β-(3′α-isopropyl)lactam-5α-pregnan-4-one (6), and E-salignone (7), were isolated from Pachysandra terminalis. The chemical structures of the new alkaloids were elucidated by spectroscopic methods. All the compounds were evaluated for their inhibitory activities against HL-60, SMMC-7721, A-549, MCF-7, and SW480 cell lines, some of the compounds showed stronger cytotoxicity for the test cell lines, especially compounds 2, 3, and 7. © 2016 Wiley-VHCA AG, Zürich