Ivorenolide A (1), a novel 18-membered macrolide featuring conjugated acetylenic bonds and five chiral centers, was isolated from Khaya ivorensis. The structure of 1 was fully determined by spectroscopic analysis, single-crystal X-ray diffraction, and bioinspired total synthesis. Both compound 1 and its synthetic enantiomer 2 showed potent and selective immunosuppressive activity.