Four lignans, sacidumlignans A-D (1-4), and two degraded lignan derivatives, sacidumols A (5) and B (6), along with four known compounds, (+)-pinoresinol, 9alpha-hydroxypinoresinol, perforatic acid, and peucenine-7-O-methyl ether, were isolated from the ethanolic extract of the whole plant of Sarcostemma acidum. The structures and relative configuration of these new compounds were elucidated on the basis of spectroscopic and chemical data, especially 2D NMR techniques. Sacidumlignan D (4) was assigned as a rearranged tetrahydrofuran lignan with an unprecedented skeleton. Sacidumlignan A (1) showed moderate antimicrobial activities against two Gram-positive bacteria in vitro.