Scabrol B and Scabrol C, two newly identified iridoid derivatives (1 and 2) and six known compounds (3–8), were extracted from the roots of Patrinia scabra. The structures of these derivatives, including their absolute configurations, were elucidated via comprehensive NMR analysis, chemical derivatization, and quantum chemical ECD calculations. All isolated compounds were evaluated for their anti-renal fibrosis activity. The results demonstrate that compounds 1 and 2 showed dose-dependent protective effects against renal fibrosis in vitro by reducing the expression of fibronectin, collagen I, and alpha-smooth muscle actin (α-SMA) in NRK-49f cells mediated by TGF-β1.