Like all of the other sapient Xen species, it has 3-fingered hands, multiple eyes, and a third appendage protruding from the middle of its chest.
Its head is so large that it must be kept upright with a small cord/string that extends from the base of the spine to the back of the head. The creature's minuscule legs appear either to be vestigial or the remains of amputation, as the Nihilanth relies on a levitation device for movement.
Physically, the Nihilanth resembles a gigantic, abnormally proportioned brownish-gray (pink in some lighting instances) fetus with a massive head atop a smaller body.