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This perennial woodland plant likes the deep shade of moist hillsides, the home of other important medicinal plans such as goldenseal and ginseng. It has robust, three-divided leaves, with three-lobed terminal leaflets. The middle lobe of the sharply-toothed leaflets is the largest. The plant is little-noticed until it sends up its tall spikes of showy white flowers, three to eight feet tall.

The root was an important folk medicine among American Indian groups and early settlers for menstrual irregularities, as an aid in childbirth and for rheumatism. Black cohosh will become of increasing interest to women looking for an alternative to estrogen therapy in the treatment of menopausal symptoms.