Tansy daisy (Tanacetum macrophyllum (Waldst. et Kit.) Schultz Bip., Asteraceae) is a perennial herb worldwide cultivated for ornamental and industrial purposes. Sometimes, this species is misidentified by herb collectors and botanists with its family mate Achillea grandifolia (white yarrow). In the present work, we have analysed the essential oil and ethanolic extract obtained from the aerial parts of tansy daisy cultivated in Italy and evaluated the biological activity in terms of cytotoxic, antioxidant and anticholinesterase activities. The essential oil was analysed by gas chromatographic and mass spectrometry (GC–MS) and showed oxygenated monoterpenes, namely camphor, linalool and 1,8-cineole, and sesquiterpenes, namely germacrene D and 10-epi-γ-eudesmol, as the major components. The ethanolic extract of aerial parts was subjected to chromatographic separation and this permitted the identification of 12 polar compounds belonging to five different classes of natural products, namely flavonoids (apigenin, cirsimaritin, apigenin-7-O-glucoside, apigenin-7-O-glucuronide, kaempferol-7-O-glucoside and kaempferol-7-O-glucuronide), dicaffeoylquinic derivatives (3,5-dicaffeoylquinic and 4,5-dicaffeoylquinic acids), caffeoylquinic acids (chlorogenic acid), free organic acids (shikimic and quinic acids) and glycosidic organic acids (4-O-β-d-glucopyranosyl-vanillic acid); among them apigenin and kaempferol derivatives were the most abundant. Finally, the essential oil from the leaves, containing high levels of germacrene D and 10-epi-γ-eudesmol, was highly effective against the proliferation of A375 (melanoma) and HCT116 (colon carcinoma) human tumor cells, showing IC50 values of 9.2 and 8.5 μg/mL, respectively. On the other hand, the ethanolic extract scavenged the DPPH and ABTS+ radicals, showing IC50 of 32.7 and 37.2 μg/mL, respectively. The inhibitory properties of tansy daisy essential oils and ethanol extract on the acetylcholinesterase enzyme were also evaluated. These findings provided new insights into the phytochemistry of the species and its possible applications on an industrial level.