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Simisage is a simian Pokémon that is primarily green. It has a pointed, bush-like crest on its head similar to a pompadour. The leaves that grow on this crest are bitter. Its ears are broad with light green insides, and it has oval eyes and a black nose. Simisage has furry, white eyebrows and shoulder tufts; and a cream-colored face, chest, hands, and feet. Its hands have five fingers, and its feet have three toes. Its tail is long and tipped with leaves. The tail is lined with tiny, sharp barbs, allowing Simisage to use it as bludgeon weapons. Simisage are prone to violently lash out at people and Pokémon for no reason.
Simisage appears to be based on a monkey and a tree; the fact that it is based on both may mean that it might be based on the legends of monkey trees or possibly a visual pun on leaf monkeys.
Its hairstyle may have been inspired by the bōsōzoku or yankee subculture. Its pompadour-like hair, common in the 50s, contrasts with the hippy-like hairstyle of Simipour, common in the late 60s and the 70s. During the 1950s, the hairstyle had become a staple of many Greaser gangs and was used by early rock and roll stars such as Elvis Presley. The early bōsōzoku took inspiration from American greaser culture.
It, along with its two contemporaries, seems to be inspired by the three wise monkeys motif; with its thumb up, Simisage represents "speak no evil".