The elktoe prefers moderate to swiftly running, cool water in mid-sized, shallow streams. It feeds by filtering microscopic food particles from the water. As juvenile mussels, they detach from their host-fish and settle to the stream bottom. Banded sculpin are known host species for the elktoe. Siltation degrades water and substrate quality and clogs the gills of filter-feeding mussels like the elktoe.
Mussels are susceptible to pollutants such as heavy metals, nutrients and chlorine.
The presence or absence of freshwater mussels is a good indicator of water quality. Any measures that would benefit the elktoe would, in turn, benefit the entire ecosystem by protecting or enhancing the water quality. It is known from three locations in WNC and one in Tennessee. One population in this state appears somewhat stable. The other two populations are in Swain County, but only one spider has been found at each of the sites in recent years.