Medeola virginiana occurs with either a single tier or two tiers of leaves. The upper tier consists of from three to five whorled leaves on the stem above a lower tier of five to nine (also whorled). Only the two-tiered plants produce flowers which are green-to-yellow and appear from May to June. When two-tiered, it grows up to 30 inches high. The waxy leaves are typically 2.5 inches long and about an inch wide, but can be as long as five inches. The leaves have an entire margin. It typically produces three dark blue to purple, inedible berries above the top tier of leaves in September.