The traditional Ethiopian medicinal plants Acokanthera schimperi (A.DC.) Schweinf. and Gnidia involucrata Steud. ex A.Rich were explored for their potential as sources of anticancer agents. Bioassay-guided fractionation yielded a previously unreported phorbol ester (5), alongside four known compounds (1–4) from G. involucrata and a pregnane-type steroid (6) from A. schimperi. Structural elucidation was accomplished through comprehensive NMR and HRMS analyses. The antiproliferative activities of these compounds were assessed against A-427, Dan-G, MCF-7, and SiSo cancer cell lines, revealing diverse levels of activity. Notably, the pregnane derivative (6) demonstrated potent activity, with GI₅₀ values ranging from 2.3 to 4.7 μM across the tested cell lines. Mechanistic investigations demonstrated that compound (6) inhibited mitotic spindle assembly and spindle-pole separation, leading to a pronounced G2/M phase cell cycle arrest in the SiSo cell line. In contrast, compound (5) exhibited potent antiproliferative activity against the Dan-G cell line (GI₅₀ = 0.3 ± 0.05 nM) and moderate to weak activity in the remaining cell lines, with GI₅₀ values ranging from 5.2 to >50 μM, inducing early apoptosis in Dan-G cells. These findings highlight compounds 5 and 6 as promising anticancer candidates and provide a scientific basis for the ethnomedicinal use of these plants in cancer therapy.