[2][3] Its common names reflect the ashy or gray appearance of the undersides of its leaves, which results from a dense pubescence.

Ashy hydrangea occurs scattered in mostly upland sites and rocky outcrops in the interior regions of the southeastern United States in the southern sections of the Blue Ridge Mountains from Tennessee to South Carolina, west to Missouri, south to Arkansas, Alabama, and Georgia.

[3] The leaves of ashy hydrangea are large (8 to 15 cm long), opposite, serrated, ovate, and deciduous.

Lower leaf surfaces are variously pubescent, appearing gray; the trichomes are usually not dense enough to entirely mask the green leaf surface; as seen under magnification, the trichomes have prominent tubercles (bumps).

Several popular cultivars ('Frosty', 'Pink Pin Cushion', and 'Sterilis') are available that have a greater component of showy, sterile flowers.