This is widespread in most eastern states, but uncommon to rare in much of the lower Ohio Valley and absent on most of the southeastern Coastal Plain. Although virtually absent now in the Bluegrass region, it may have been more frequent here. In his notes on flora of the Lexington area (FAYE), Short (1828) stated: "Of this extensive genus [Orchis sensu lato], the present subject is the only species I have met with in this neighbourhood... A few years since this occurred frequently in moist rich woods; it has now, however, almost disappeared before cultivation and the ravages of cattle." Remarkably, Liz Hobson (pers. comm.) discovered a plant along Marble Creek in JESS during 2016. Basal leaves of Galearis can be confused with those of Clintonia, which is often associated, but they differ as folllows (FNA 26): numbering 1`-2 (versus 2-6); 9-20 x 2-10 cm (versus 18-30 x 4.5-8 cm); elliptic, obovate or suborbicular (versus obovate to oblanceolate); apex obtuse (versus acute to acuminate); glabrous and glossy (versus thinly villous and dull).