Episilvestrol is a semisynthetic derivative of silvestrol, a natural flavagline isolated from plants in the Aglaia genus (family Meliaceae). It is primarily studied for its potential in cancer therapy due to its ability to inhibit protein synthesis in cancer cells. It targets the eukaryotic translation initiation factor 4A (eIF4A), which is crucial for the growth and survival of cancer cells. By disrupting this process, it can effectively induce cell death in malignant cells while sparing normal cells, making it a promising candidate for selective cancer treatment, particularly in breast and colorectal cancers. Additionally, research indicates antiviral properties, especially against respiratory viruses like influenza. Ongoing studies explore its efficacy in various cancer types, its antiviral applications, and potential use in combination with other therapeutic agents to enhance outcomes. Further research is needed to confirm safety and efficacy for human use.