The newest of the green, pointed tubercles on Euphorbia caput-medusae stems are tipped with leaves in the centres of the stem tops.

The fleshy leaves are stalkless and erect, oblong in shape and slightly curving with rounded to pointed tips. Leaf colour is green or blue-green on the margins, whitish grey on the blades.

Around the leaves the ring of false flowers or cyathia reach roughly the same height as the leaves, growing from the gaps between tubercles, not from their tips. The long stalks of old flowers are visible in the top right of the picture.

Other stem surfaces show the skewed tubercles without appendages, only the white spots at the tips where leaves had grown earlier (Frandsen, 2017; Manning and Goldblatt, 1996).