Evergreen shrub or small tree up to 6(–7) m tall; bark brown, deeply fissured; young branches reddish, glabrous, conspicuously angled and ribbed. Leaves decussately opposite, simple and entire; stipules absent; petiole 2–6 mm long; blade obovate to elliptical, 4–13.5 cm × 1.5–8 cm, base cuneate or rounded, apex acute, obtuse or rounded, with hard mucro, leathery, glossy, usually glabrous, pinnately veined, lateral veins prominent, without looping connections. Inflorescence a dense axillary cyme, many-flowered. Flowers bisexual, regular, 5-merous, fragrant; sepals free, ovate to lanceolate, (1.5–)2–3.5 mm long, apex acuminate to acute, shortly hairy or glabrous outside, ciliate; corolla tube cylindrical, 6.5–20 mm long, shortly hairy outside, inside sparsely hairy in the upper half and wrinkled below, pink or red, lobes broadly elliptical, 2–5 mm long, apex acute, shortly hairy on both sides, ciliate, white; stamens inserted at 12.5–15 mm from the base of the corolla tube, slightly exserted; ovary superior, ellipsoid, 2-celled, style slender, 11–16 mm long, stigma minutely bifid. Fruit an ellipsoid berry 1.5–3(–4) cm long, purple when ripe, pulp green to deep red, 1–2-seeded. Seeds ellipsoid, plano-convex, 6–10 mm long, smooth, glabrous.

Stomachic, emmenagogue and anthelminthic (root)

PROTAbase: Acokanthera oppositifolia

A small amount of the leaves is eaten, a leaf or root decoction is drunk and the leaf or root pulp is rubbed into the wound to treat snakebites and spider bites. Alternatively, root powder is sniffed and a dressing made of roots or leaves is put on the swollen part. A root infusion is taken to treat syphilis. Root powder or leaf powder is sniffed to cure headache, while a leaf infusion is used as a nasal spray for this purpose. Small pieces of the stem are chewed against toothache. A leaf infusion is taken to treat abdominal pain, colds, measles and blood poisoning. A root infusion is taken to expel tapeworm and to treat excessive and irregular menstruation.