Rhizomes: internodes short, leaves crowded at rhizome apex. Leaf blade cordate, 6-10 × 5-9 cm. 2 n = 26.

Flowering spring-early summer (May-Jul). Acidic soils, often along creeks beneath Rhododendron maximum , deciduous or mixed deciduous-conifer forests; 400-1300 m; Ala., Ga., N.C., S.C., Tenn., Va.

H. L. Blomquist (1957) reported Hexastylis shuttleworthii var. shuttleworthii from Morgantown in northern West Virginia; we have not seen this specimen.