Melicope makahae are shrubs or shrubby trees that can reach up to 3 meters in height. A dense covering of puberulent hairs characterizes the new growth and young branches. The leaves are simple and opposite, with narrowly ovate to elliptic blades measuring 9.5–12 cm in length and 1.5–5 cm in width. The apex is bluntly acute or slightly rounded, and the base is cuneate. The upper surfaces of the leaves are glabrous, while the lower surfaces are densely covered with strongly appressed, extremely fine hairs mixed with a fine white waxy scurf and are glandular punctate. The lower surfaces are grayish-green and coriaceous. The leaf margins are usually revolute and entire. The primary lateral veins, usually 8–12 pairs, are slightly raised on the lower surface and connected by an arched vein 1–5 mm from the margin. The venation is pinnate, with lateral veins connected by an arched submarginal vein and higher-order venation forming a reticulate pattern. Petioles are 10–22 mm long and densely puberulent. Stipules are absent. The flowers, ranging from 1 to 7, are presented in densely grayish puberulent cymes with peduncles measuring 10–30 mm long and pedicels 5–10 mm long. Bracteoles are lanceolate, 1.5–3 mm long, densely grayish puberulent. The calyx consists of 4 sepals, ovate, 2.5–3 mm long, and variably puberulent. The corolla comprises four valvate, deltate petals, approximately 5 mm long, densely puberulent on both sides or only externally. The stamens are rudimentary in pistillate flowers, and there are eight stamens in 2 whorls in staminate flowers, distinct but always present in functionally pistillate flowers. The ovary is superior, glabrous, 4-celled and 4-lobed, with carpels connate and slightly distinct at the apex to almost entirely distinct; ovules are 2 per cell, hemitropous, one ascending; the style terminates in 4 short stigmatic branches. The fruit is dark green, 20–24 mm wide, composed of distinct follicles, each 10–15 mm long; the exocarp and endocarp are glabrous. The carpels dehisce along the upper suture. Each follicle contains two seeds, 4-5 mm long, glossy black when ripe, crustaceous, ovoid, sometimes angled from compression, with a straight embryo in fleshy endosperm. The radicle is short, cotyledons compressed, ovate, putamen brown, and warty. It is found in mesic forests on ridgetops and upper gulch slopes between 670-1,220 meters.