The flowers are usually single. The sepals are green, the petals white. The lower petal is pouchlike and has deep reddish-purple spots inside. Spotted lady's slipper has shallow rhizomes. Plants will grow in groups of 1 to 137.
Vegetative recruitment is more prevalent for spotted lady's slipper than seedling establishment.
The plant is self-compatible, but seed set for these is unknown. It can take 15 years from seedling establishment to flowering. The flower exit hole is only 2.5 to 3.0 mm wide, which restricts the pollinator size. Spotted lady's slipper grows in moist to wet spruce forests at low elevations. It often occurs on calcareous substrates.