The erect, succulent leaves of Cephalophyllum pillansii are more cylindrical than triangular in cross-section, their tips pointed. The hairless leaves are blue-grey covered in a waxy coating. They grow in clusters at the spaced nodes of short, prostrate stems. 

The generic name of Cephalophyllum is derived from the Greek words cephalos meaning head and phyllon meaning leaf. It refers to the tendency of the leaves to grow in dense heads on stems with longish internodes. Some other Cephalophyllum species have their leaves more markedly concentrated in such separate balls.

C. pillansii leaves appear very diverse in size on the plants (Smith, et al, 1998; Herre, 1971; iNaturalist).