Abstract The antiproton-nucleon effective interaction evaluated in nuclear matter is used to construct the p- nucleus optical potential. It is found that the resulting optical potential is largely modified by the nuclear medium to be attractive in the inner region of the nucleus, strongly absorptive and moderately energy-dependent at the energies concerned here ( E ≲ 180 MeV). The differential cross sections for elastic and inelastic p- nucleus (C, Al, Ca, Cu and Pb; only C for the inelastic case) scattering are calculated. The results obtained with the medium-corrected optical potential are in better agreement with experimental data than those with the free t-matrix. Within the measured range of the scattering angle, however, the effect of the medium correction on these quantities does not seem to be quite so prominent in spite of the drastic change of the optical potential. The spin-orbit component of the optical potential is also evaluated and found to be largely suppressed in the nuclear medium. The calculated polarization is very different from that obtained with the free t-matrix. Therefore the first measurement of the polarization should be a crucial test of the applicability of our approach.