Euphorbia caput-medusae is a succulent growing many finger-like stems from a short, underground caudex. The stems may be straight and erect or decumbent and curving. When the latter shape occurs the resemblance to writhing serpents warrants the comparison to a Medusa head or caput-medusae, of the specific name. In Afrikaans the plant is called vingerpol (finger tuft), a name shared with several other Euphorbia species.

These plants grow from close to Cape Town in a broad strip up the west coast to the Gariep River and beyond in Namibia. The habitat is coastal sand flats and rocky hills, particularly. The species is not considered to be threatened in its habitat early in the twenty first century (Frandsen, 2017; Bond and Goldblatt, 1984; www.plantzafrica.com; www.redlist.sanbi.org).