<p><em>Sapium macrocarpum</em> (Euphorbiaceae) is a tropical tree located mainly in the southern part of Mexico and in Central America, and it is used in the Mayan traditional medicine for the treatment of several skin diseases. The dichloromethane-MeOH extract of the aerial parts displayed cytotoxic activity against certain cancer cell lines. Lupeol (<strong>1</strong>), lupenone (<strong>2</strong>), sitostenone (<strong>3</strong>), β-sitosterol (<strong>4</strong>), stigmasterol (<strong>5</strong>), sitosteryl β-D-glucopyranoside (<strong>6</strong>) and the rare diterpene tonantzitlolone A (<strong>7</strong>) were characterized from this extract. The structural analysis allowed the <sup>1</sup>H NMR reassignments for H-12α and H-12β, and for H-13α and H-13β of tonantzitlolone A (<strong>7</strong>). The cytotoxic activity of compounds <strong>1-3</strong>, <strong>6</strong> and <strong>7</strong> was evaluated against selected cancer cell lines. Compounds <strong>3</strong>, <strong>6</strong> and <strong>7</strong> displayed clear activity against K562 (leukemia). This is the first report on the chemical constituents of <em>S. macrocarpum</em>, and points out that this species is an additional source of tonantzitlolone A. Compound <strong>7</strong> has only been reported previously from species of the <em>Stillingia</em>, <em>Sebastiania</em> and <em>Sapium genera</em>, which belong to the Hippomaninae subtribe of the family Euphorbiaceae.</p>