Cypripedium macranthos has a widespread distribution across Russia (European Russia and Siberia), Kazakhstan, Mongolia (Huvsgul, Hentii, Mongol Daguur, and Khyangan), Japan, Korea, China (Hebei, Heilongjiang, Jilin, Liaoning, Nei Mongol, and Shandong provinces) and Taiwan.

[3][4] C. macranthos is similar in appearance to Cypripedium tibeticum, which has slightly larger, darker flowers.

[3][6] Cypripedium macranthos is listed as least concern by the International Union for Conservation of Nature in light of its large distribution and low risk of extinction, however, the population is declining.

The abundance of C. macranthos has been significantly reduced in the last few decades due to climate change, deforestation, erosion, overgrazing, poaching, tourism, and urbanization.

[1] C. macranthos is conserved ex situ in many botanic gardens, and international trade of the species is regulated under Appendix II of the CITES treaty.