(Rac)-Hydnocarpin is a natural flavonolignan derived from the flowers of Pueraria lobata that demonstrates strong cytotoxic effects against multiple ovarian cancer cell lines while maintaining minimal toxicity toward normal ovarian surface epithelial cells. (Rac)-Hydnocarpin triggers intrinsic apoptotic signaling through activation of caspase-9 and caspase-3 with limited involvement of caspase-8, driven by reactive oxygen species generation as a dominant mediator of apoptosis. (Rac)-Hydnocarpin additionally reprograms tumor-associated immune cells by reducing M2 macrophage markers and pro-tumoral mediators including matrix metalloproteinase-2/9, C–C motif chemokine ligand 5, transforming growth factor-β, and vascular endothelial growth factor, while enhancing macrophage phagocytosis, reinforcing its role as a multifunctional anticancer agent.