The simple, opposite leaves of Carissa macrocarpa grow on petioles up to 5 mm long and grooved on top. The leaves have no stipules, but the axillary glands are conspicuous. The green spines have reddish tips.

The leaf shape is broadly ovate, the apex more or less tapering or rounded, ending in a bristle-tip or mucro. The leaf base is square to rounded. Leaf dimensions are 2,5 cm to 7 cm by 1,5 cm to 3,5 cm.

Leaf margins are entire. The midrib is conspicuous, the lateral veins obscure. The leathery and hairless leaves are glossy green above and paler below. In the photo faint red colouring is present on the shiny new growth. The young leaves are convex above, the midrib sunken (Coates Palgrave, 2002; www.plantzafrica.com).