Conophytum truncatum can be distinguished from its closest relatives by its truncated, flattened heads, with small fissures.

The common Conophytum piluliforme (occurring across the Montagu-Ladismith Karoo) has small (less than 5 mm x 5 mm), obconical, "pill-shaped" ("piluliforme") heads, with few or no spots and pink or purple flowers.

The Conophytum ficiforme (restricted to the Breede River valley) has raised, keeled, "fig-shaped" bodies, with distinctive spots that are clearly arranged in angular, (horseshoe-shaped) lines over their heads.

[2] The easternmost of all Conophytum species, C. truncatum is indigenous to the Little Karoo region, and its surrounds, in the southern Cape of South Africa.

They inhabit extremely well-drained soil, in spots protected by rocks or bushes.