The soft, blue-green leaves of Othonna macrophylla grow in sub-opposite pairs, well-spaced between successive pairs. There are no hairs on the blade surfaces that are somewhat rubbery.

The leaves grow mostly near the plant base where they are largest. The few upper-stem leaves decrease in size quite abruptly. Each leaf-pair is only sub-opposite or nearly opposite, the leaves sessile (stalkless) and stem-clasping.

The whitish midrib on the blade is conspicuous, the variable lateral veins less so, spaced and ascending. These veins become faint, sometimes not visibly reaching the margins (iNaturalist; JSTOR).