This is a remarkable, late-flowering, twining herb with spreading rhizomes and tubers. It has a largely Appalachian range but also scattered west to s. Ohio, s. Ind. and Mo. (K). It is imperiled across much of its range, and reportedly secure only in W.Va. and Va., especially among the higher mountains (Heikens 2003a; NS, W). In Ky., it is known only from the Appalachian Cliff Section or nearby. Across the Ohio Valley. the few records are from small, widely scattered patches, and it has disappeared from some localities. These sites are mostly in thin woods and edges on terraces and toe slopes with sandy soils, adjacent to floodplains or old fields on lowlands (in some cases with remnants of ancient "barrens"). Stressed or shaded plants may gradually decline but can persist for some years with non-flowering stems from tubers, which are rarely collected for herbaria. The tubers and seeds of most Aconitum species are known to contain powerful diterpene alkaloids that have had various medicinal or toxicological uses, but there is no definitive information published about toxicity or medicinal uses of uncinatum (FNA 3; Zhao et al. 2025). Axilllary bulbils have also been reported in this species, but not in Ky. (Heikens 2003a; and her citations).