This research delves into the medicinal significance of Smyrnium olusatrum by investigating ethyl acetate, ethanol, ethanol/water, and infusion extracts. The chemical composition analysed through LC-MS-qTOF metabolomic analysis, determine total phenolic and flavonoid contents, evaluate antioxidant potential using six in vitro tests (DPPH, ABTS, FRAP, CUPRAC, phosphomolybdenum assay (PBD), and metal chelating assay (MCA)), assess enzyme inhibition activity against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), tyrosinase, α-amylase, and α-glucosidase, and explore their anticancer effects on HEp-2 cells. Additionally, qPCR analysis is conducted on HEp-2 larynx cancer cells to examine the impact of S. olusatrum on self-renewal and apoptosis pathways, along with the expression levels of key genes associated with these pathways. The findings indicated that the infusion extraction method demonstrated the highest levels, with a recorded TPC of 35.02 mg GAE/g and a TFC of 15.08 mg RE/g. All four extracts of S. olusatrum exhibited a total of 328 entities. The most significant metabolites, primarily comprising polyphenolics, flavonoids, non-structural carbohydrates, and amino acids in negative ionization mode, as well as sesquiterpene lactone and amino acids in positive ionization, were identified. Infusion exhibited the highest antioxidant effect among the extracts, with peak values ranged from 55.55 mg TE/g (DPPH) to 100.07 mg TE/g (ABTS). The extracts exhibited variable enzyme activities. Notably, ethyl acetate also demonstrated superior α-Amylase inhibition (0.69 mmol ACAE/g), while the ethanol extract exhibited higher α-Glucosidase inhibition (1.70 mmol ACAE/g). The HEp-2 cells demonstrated the quickest attainment of half maximal inhibitory concentration values with ethanol and ethanol/water extracts, yielding IC50 values of 250 µg/mL (24 h) and 125 µg/mL (24 h), respectively, among the applied extracts. The qPCR results revealed that S. olusatrum inhibited all self-renewal pathways and activated the apoptotic pathway. The ethanol and ethanol/water extracts of S. olusatrum significantly suppressed WNT1, APC, LEF1, and TCF7 genes. Furthermore, the downregulation of NOTCH1, SHH, and SMO gene expressions in all extracts suggests the activation of the Type 1 non-canonical hedgehog pathway in laryngeal cancer. The findings not only underscore the therapeutic potential of these extracts but also open the way for further exploration of their applications in combating oxidative stress, enzyme-related disorders, and potential anti-cancer effects through modulation of crucial cellular pathways.