Like other members of its genus, ʻiliahi is a root hemi-parasite, deriving some of its nutrients from the host plant; common hosts include koa (Acacia koa), koaiʻa (Acacia koaia), and ʻaʻaliʻi (Dodonaea viscosa).

Native Hawaiians used the wood to make pola, the deck on a waʻa kaulua (double-hulled canoe).

[6] Between 1791–1840, trees were intensively harvested for export to China, where the hard, yellowish-brown wood was made into carved objects, chests, and incense.

[7] Native Hawaiians combined leaves and bark of the ʻiliahi with naio (Myoporum sandwicense) ashes to treat kepia o ke poʻo (dandruff) and liha o ka lauoho (head lice).

ʻIliahi shavings mixed with ʻawa (Piper methysticum), nioi (Eugenia reinwardtiana), ʻahakea (Bobea spp.