The genus is native to temperate, subarctic and arctic regions across most of Europe, northern Asia (Siberia, China, the Himalayas, Central Asia, etc), and North America, with a few species extending into subtropical regions in the Mediterranean, Indochina, the southeastern United States, etc.

[1][3][4][5][6] Neottia produces a racemose inflorescences with flowers in shades of green or dull pink through to maroon and purple.

Others (the formerly narrowly defined genus Neottia) lack chlorophyll and are dependent on fungi for their nutrition (mycotrophic).

In the photosynthetic members of the genus there are also two more-or-less opposite green leaves (very rarely more than two in Neottia ovata).

The flowers are individually small, in shades of green, yellow, brown or red to purple.