Citreamicin ε is a group of antitumor compounds produced by Streptomyces species. Cytotoxicology study of two diastereomers, citreamicin ε A and B, showed different apoptotic effects on PtK2 cells with IC 50 (half-maximal inhibitory concentration) values of 0.086 and 0.025 µM, respectively. Thus, we performed an iTRAQ (isobaric tags for relative and absolute quantitation)-based quantitative proteomic analysis to reveal the mechanism of cytotoxicity of citreamicin ε A and B in PtK2 cells. A total of 1,079 proteins were identified and quantified, among which 103 and 94 proteins displayed significant changes in expression levels after the treatment of citreamicin ε A and B, respectively. These significantly differentially expressed proteins (DEPs) were further annotated by Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and proteinprotein interaction analysis, which revealed the involvement of eight molecular pathways. Among them, expression trends of proteins involved in the nuclear transcription factor κB (NF-κB) pathway displayed the opposite between the two diastereomer treatments, indicating different modes of action of these two compounds. Citreamicin ε A treatment induced rapid activation of the NF-κB pathway, which might promote cell survival and resulted in lower toxicity. Our comparative proteomic analysis provided molecular evidence on the toxicity of two diastereomers compounds to cells, which may shed new light on future mechanism study of these antitumor compounds.