The stems of Euphorbia caput-medusae do not always become long as seen in higher rainfall areas such as the south of the species distribution.

This well-shaped plant keeping its head(s) above sand shows leaves, cyathia and fruit on short stubby branches of similar length. Upper tubercles are pinkish purple, lower ones dull grey-green (Frandsen, 2017; Manning and Goldblatt, 1996).