Eleutheroside E is one of the active constituents of the Eleutherococcus senticosus (Rupr. & Maxim.) is also called Harms (ES), Acanthopanax senticosus, Siberian ginseng, or Gasiogapi in Korea. It is a diastereoisomer of Eleutheroside D. Eleutheroside E (EE) significantly decreased the inflammatory cell infiltration, pannus formation, cartilage damage, and bone erosion of collagen-induced arthritis mice, highlighting Eleutheroside E as a potential therapeutic agent for rheumatoid arthritis. Treatment of rat mesangial cells with Eleutheroside E markedly attenuated high glucose induced cells proliferation and in a dose-dependent manner. Intervention with EE also significantly blocked high glucose induced intracellular ROS production by decreasing NADPH oxidase activity. Intervention with EE also significantly blocked high glucose induced intracellular ROS production by decreasing NADPH oxidase activity. EE mediates the hyperglycemic effects of Eleutherococcus senticosus by regulating insulin signaling and glucose utilization. The beneficial effects of EE may provide an effective and powerful strategy to alleviate diabetes. Eleutheroside E exhibited weak inhibition against CYP2C9, CYP2E1 activity, and no effect on CYP2D6 and CYP3A4. The inhibition can result in the increase of the plasma concentration and toxicity of concomitant drugs, especially for those with narrow therapeutic windows such as warfarin, phenobarbital and phenytoin.