A sensitive and specific liquid chromatography–tandem mass spectrometry method was developed and validated for the first time for the estimation of Tenacissoside A in the rats’ plasma, which is the major active constituent in Marsdenia tenacissima. Tenacissoside A was extracted from the rats’ plasma by using liquid–liquid extraction (LLE), medroxyprogesterone acetate was used as the internal standard. An Alltech C18 column (250 mm × 4.6 mm, 5 μm) was used to provide chromatographic separation by detection with mass spectrometry operating in selected ion monitoring (SIM) mode. The method was validated over the concentration range of 1–250 ng/mL for Tenacissoside A. The precisions within and between-batch (CV%) were both less than 15% and accuracy ranged from 90 to 102%. The lower limit of quantification was 1 ng/mL and extraction recovery was 88.3% on average. The validated method was used to study the pharmacokinetic profile of Tenacissoside A in rat after administration.