Emetine alkaloids are a class of highly potent antimalarial and antiemetic natural products derived from the plant species _Euphorbia antiquata_ and _E. echinata_. These compounds contain a unique spiroketal structure, which is essential for their biological activity. Emetine exhibits strong cytotoxicity against various cancer cell lines, making it of significant interest in both antimalarial therapy and chemotherapy research. In clinical settings, emetine has been used to treat malaria caused by _Plasmodium falciparum_. Its antiemetic properties have also led to its application as an adjunctive treatment for nausea and vomiting associated with certain medical conditions, including postoperative nausea and vomiting (PONV). Despite its effectiveness, the use of emetine is limited due to potential severe side effects such as liver toxicity and cardiovascular arrhythmias. Ongoing research aims to develop derivatives or analogs of emetine that retain their therapeutic benefits while mitigating these adverse effects.