Eight new sesquiterpene alkaloids (1-8) and four known sesquiterpene alkaloids (9-12) have been isolated from the roots of Maytenus mekongensis. Structures were determined using extensive spectroscopic methods. The relative configuration of 7-epi-mekongensine (2) was established by single-crystal X-ray crystallographic analysis. The alkaloids were evaluated for antiplasmodial activity against Plasmodium falciparum, K1 strain, and for cytotoxicity using a panel of cell lines.