Found in Asia, Mediterranean Africa, and Europe, fruit bodies (mushrooms) grow scattered or in groups on the ground under conifers, especially Douglas fir.

When bruised or cut, the fruit bodies ooze a blood-red to purple latex that slowly turns greenish upon exposure to air.

[6] Because Paulet's 1811 type illustration of the species did not represent the typical morphology of the fruit bodies, Jorinde Nuytinck and Annemieke Verbeken designated an epitype in 2005.

[8][9] Later authors did not agree with the delimitation of these forms as distinct taxa, suggesting that the alternations in appearance represent normal morphological variations brought about by differences in age, and environmental factors such as levels of sunlight and humidity.

[2] Lactarius vinosus has often been considered as a variety of L. sanguifluus, but morphological (especially macroscopic characters and spore-ornamentation) and molecular evidence (based on internal transcribed spacer-sequencing) has confirmed that they are separate species.

The flesh ranges from firm to fragile: in the stipe, it is soft and pale pinkish buff; under the cap cuticle it is brick colored, or brownish-red just above the gills.

[15] An ectomycorrhizal species, Lactarius sanguifluus fruit bodies grow on the ground in association with pine trees on calcareous soils.

L. sanguifluus is widely distributed in Himachal Pradesh in India, where it has been noted to grow in mixed coniferous forests, usually under the fern Onychium contiguum.

[2] In the Netherlands, it was found in calcareous dunes, growing in a warm, sunny and sheltered place at the edge of a woods dominated in pine species.

[17] From Europe, it has also been recorded in Belgium,[18] Estonia,[19] Greece,[20] Cyprus, France, Germany, Italy, Luxembourg, the Netherlands, Poland, Russia,[19] Spain, Slovakia, Sweden,[2] and Switzerland.

This was noted by Paulet in his original description of the species, who wrote: "This fungus is highly prized for use by those who are acquainted with it, it keeps well: I kept them for a whole year, it hardens without spoiling, then it takes on a taste of morels.

In Cyprus, it is known as γαιματάς (meaning "the bloody one") and it is widely collected by the locals, but considered inferior to the saffron milk cap (Lactarius deliciosus).

[35] In a Turkish study of various edible mushroom species collected from lawns, near roads, and the inner parts of forests, the fruit bodies of L. sanguifluus were determined to have accumulated high levels of zinc, manganese, nickel, cobalt, cadmium, and lead.