The morphology and anatomy of the Cephalocereus columna-trajani flowering region was described and compared with data on other species. The vegetative and reproductive regions were described in detail. The results showed that after the flowering region is differentiated, morphological changes take place which are correlated with anatomical changes. The flowering region in this species is termed a lateral cephalium because of its reduced interareolar space, increased areole size and abundant long bristles and trichomes in the areoles. Periderm development near the apical meristem, lack of chlorenchyma and a delay in xylem fiber differentiation are also traits characteristic of a lateral cephalium. The lateral cephalium of C. columna-trajani shared the same combination of morpho-anatomical characters with its sister taxon, C. senilis, except for the number of ribs in the cephalium. Both species survive in high temperature environments and their cephalium faces north; however, only C. columna-trajani tilts, thus we hypothesize that incorporation of fewer ribs associated with periderm development in the cephalium contributes to stem tilting.