Found in shady lowland forest with little undergrowth, especially under beech trees, occasionally spreads onto chalk scrub.

[3] This species is found in Europe from England and Sweden to Russia and Iran; also Bhutan, India, Myanmar and Yunnan.

A 2017 investigation found that in Italy mycorrhizal associations are formed with Agaricomycetes, Ascomycota, Cadaphora luteo-olivacea, Cenococcum geophilum, Ceratobasidium including C. cornigerum, Cryptococcus carnescens, Exophiala salmonis, Hymenogastraceae including Hymenogaser cytrinus and H.

[5] It has been suggested that the presence of this orchid species in a woodland is an indicator that edible truffles can be found there,[6] but this is not always the case.

[3] Cephalanthera comes from the Greek κεφαλή ανθηρός, meaning "head flowering", thought to be a reference to the protruding position of the anthers.

The species epithet damasonium also comes from Ancient Greek and means 'I take away/diminish', possibly referring to a medical use for the plant.