23-Hydroxybetulinic acid is a cytotoxic agent from rizoma of Pulsatilla chinensis (Bunge) Regel. Anticancer activity of 23-Hydroxybetulinic acid is associated with depolarizations of the mitochondrial membrane potential and subsequent cell apoptosis. Additionally it induces autophagic cell death in HL-60 cells via the up regulation of Beclin-1.