This rhizomatous species, with distinctive flexuous stems and auriculate-clasping leaves, occurs in a relatively narrow range from mid-Atlantic states (Mass. and Va.) to midwestern states (Minn. and Iowa). Although Cr reported a range of reported chromosome numbers (2n = 32, 48, 64), there has been virtually no recognition of segregates. S. prenanthoides usually grows along banks of smaller streams and on damp adjacent terraces and slopes, generally in medium acid soils. In Ky. it is widespread in Appalachian regions. Further west it is much more restricted but locally common in hilly sections of the Bluegrass and Knobs regions, where flowers are sometimes much paler blue to white (e.g. at Jacobson Park in FAYE). Cultivated plants in Lexington (FAYE) are often broswed by rabbits. In summer, this species and its allies (such as puniceum) can be distinguished from the dumosus group (section Dumosi) by their relatively broad leaves (the lower ones often ovate) with more or less clasping bases. However, these differences become less clear late in the year.