This strict biennial ranges through much of the central Mississippi River and Ohio River watersheds, but with some extension into adjacent Appalachian lowlands. It typically grows in thin woods on toe-slopes and terraces with damp fertile soil. Seedlings establish in spring then flower after one winter in May; the species is easily established in shady urban gardens of the central Ohio Valley. It was formerly much more widespread in this region before woodland clearance and intensive grazing by livestock; plants are also often clipped back by rabbits and deer. Overwintering leaves are often mottled, as in macrophyllum.