Amphisbaena caeca is pinkish-brown on the head and tail, with dark spots on each of the scales found throughout its annuli (body rings), of which there are between 214 and 237 in this species.

It is one of the two largest amphisbaenids on the island (the other being A. bakeri), measuring up to 10 inches (250 millimeters) in snout to vent length (SVL).

Because it is somewhat difficult to distinguish its head from its tail, it is sometimes referred to as a "two-headed snake" ("culebra de dos cabezas") by Puerto Rican locals.

They can be found burrowing in the ground under logs, rocks, old tree stumps, and under termite and ant nests.

The distribution of this species is the widest of any amphisbaenid in Puerto Rico, being found throughout the central mountainous region of the island up to an elevation of 2,200 feet (670 meters).