The opposite leaves of Buxus macowanii, an evergreen, are ovate-lanceolate to elliptic, varying in size from 6 cm to 11 cm in length and 2 cm to 5 cm in width. They are shiny dark green, thinly leathery and hairless. Leaf shape tends to vary across the geographical distribution of the species.

The petioles are short and thick, running along a ridge into the leaf base. Leaf midribs are prominent, especially in the lower half of the leaf. Leaf margins are entire and gradually undulating (Coates Palgrave, 2002; Schmidt, et al, 2002; Van Wyk and Van Wyk, 1997).