The leaves of Pachypodium bispinosum grow on thickish pale green stems that emerge from the top of the partly above-ground, bulky caudex. These stems become long (up to 1,2 m) and tend to curve down under their own weight. The stems are armed with pairs of straight spines, from 1 cm to 2 cm long, scattered along stem surfaces; not many of them to be seen in the photo. The specific epithet of bispinosum is a bit ironic as all the Pachypodium species have such paired spines.

The leaves, also scattered or in tufts, are dark green, narrow and lanceolate with prominent whitish midribs. The leaf margins are entire and curl down slightly. The leaves become about 15 mm long and 5 mm wide.

The flowers are widely tubular or bell-shaped, each topped by five rounded corolla lobes. The flower tubes are about 8 mm in diameter. Flower colour varies from pink to purple, the tube usually darker than the lobes. Flowering happens in late winter through summer, the first flowers and new leaves appearing concurrently (Vlok and Schutte-Vlok, 2010; www.plantzafrica.com).