The leaves of Acmadenia alternifolia are alternate as the specific name says, although they appear here to spiral around the stems, becoming imbricate. The ericoid leaves are sessile, ascending up the stems and curving in. The inner surface of the leaf is flat or concave, the outer one bulging or convex with a prominent keel and some longitudinal ribs.
The leaves grow on finely hairy branches that are creamy yellow or red near the top, the leaves less densely clustered below the tips. Low down on old shrubs the stems are grey, woody and leafless (iSpot; JSTOR).