Plants 20-60(-106) cm, sparsely hairy. Leaves 5-10; blade orbiculate, elliptic, or narrowly lanceolate, 4-10 × 1.5-4.5 cm. Inflorescences lax racemes, usually secund; floral bracts lanceolate, 10-35 mm, often exceeding flowers. Flowers 8-18, dark wine to cranberry red, small; sepals dark wine red, rarely dull rose or greenish abaxially; lateral sepals 6-7 mm; petals similar to sepals in color, ovate, 4-7 × 2-4.5 mm; lip indistinctly veined, 5.5-6.5 mm, constricted at middle into 2 parts, proximal part greenish with red edges, deeply concave, adaxial surface spotted with violet-red or brown, distal part brighter and darker, broadly triangular or transversely elliptic, minutely toothed with small reflexed tip; calli 2, brownish, brighter, darker in color than lip, rugose; column very short, 2-3 mm; anther yellow; pollinia 2 pairs, yellow, mealy; ovary tomentose. Capsules ovoid, 7-9 mm, moderately to densely tomentose. 2n = 40.

Flowering Aug. Partial shade in abandoned serpentine/asbestos quarry; 700 m; introduced; Vt.; Europe; Asia (Iran).

Epipactis atrorubens is apparently naturalized in Vermont where a small population persists (P. M. Brown 1997).