It lives in the southern United States, and has a complex life history including its larvae being parasitic on a fish host.

[4] It is found buried in the sand or gravel at the bottom of riffles and glides and sometimes slower moving stretches of water, but not in lakes.

[4] Like other fresh water mussels in the family Unionidae, the Ouachita creekshell has a complex life history involving a larval stage known as a glochidium which attaches itself to the gill, fin or skin of a suitable host fish.

[4] The female Ouachita creekshell produces a lure for potential host fish consisting of movements of papillae on the foot creating a wave action of the mantle.

Fish that investigate this get showered in glochidia which have been brooded within the mussel's mantle cavity over the winter period.

This means that it is of special concern as it is very rare, either having fewer than 20 localities at which it is found or having a small number of individuals at only a very few locations.