This has been cultivated in northeastern states; its expanded sterile ray flowers are a notable showy feature, especially in the "Snowball" cultivar (somewhat parallel to variation in Hydrangea). The species has occasionally escaped or persisted after cultivation. In Ky. some colls. may be from self-seeded plants, but other records have less certain status. A coll. by K. Carr (20 Jun 1936) from "swamp... Rodburn" in ROWA (MDKY) may be the closely related northern species, V. trilobum Marsh. (= V. opulus var. americanum Ait.), but label data are dubious (Campbell et al. 1992). The latter can be distinguished by its petiolar glands (W), which are mostly taller than wide, stalked, rounded on the top (versus mostly wider than tall, sessile, concave). Also, trilobum leaves tend to have more elongated central lobes, with less toothing..V. opulus has had ancient medicinal use, especially the bark for cramps and the fruit for antioxidants (Česonienė et al. 2010).