The opposite, spaced leaves of Pachycarpus natalensis grow on short, thick, sometimes reddish stalks, ascending up the creamy green stems.

The leaf-shape is ovate to oblong tapering to pointed tips and wedge-shaped to rounded bases. The margins are entire, slightly wavy with a pale, slightly thickened rim. Leaf dimensions are 4 cm to 8 cm long and 2 cm to 4,5 cm wide.

The pale midrib is prominent on the lower surface. The medium to dull green blades, usually hairy, have ascending lateral veins positioned close together. These veins are not quite straight and joining each other near the margins without reaching it (Pooley, 1998; iNaturalist; http://pza.sanbi.org).