The stems of Pachypodium saundersii, the kudu lily, are swollen with much stored clear sap. The stem may bulge conspicuously on older plants at the base above ground, giving the plant a strikingly attractive look. The stem surfaces are smooth and grey to yellowish, while this young plant living comfortably in garden semi-shade has an olive-green stem. The leaf surface on old stems sometimes appears patchy with varying colour in different areas. Several branches of irregular, contorted shape grow from the main stem.

Leaf stipules arise at the base of each leaf or fascicle of leaves, growing on a small cushion. The stipules transform into long straight spine pairs.  Some tend to drop off over time, so that spines occur only sparsely on older stems, while young stems show high density of spines where leaves have dropped off recently.

The leaves are scattered along the upper stems or grow in fascicles. Leaves are simple with entire, slightly wavy margins. Leaves are stalkless. Lower leaf surfaces are hairy, have tiny spines or are smooth. The leaf shape is elliptic or obovate, folding in along the whitish midrib (Letty, 1962; Manning, 2009; Germishuizen and Fabian, 1982).