Plants 5-35 cm. Stems slender, succulent, glabrous. Leaves: blade dark green, ovate-reniform, 2-4 × 1.5-3.5 cm, apex acute, mucronate, or apiculate to short-acuminate. Inflorescences 5-15-flowered, lax, 40-100 mm; floral bracts ovate, 3-4 × 1.5 mm, apex acute; peduncle and rachis glandular-pubescent. Flowers green, purple-brown, to pinkish tan; pedicel slender, 6-7 mm, glabrous; sepals strongly reflexed; dorsal sepal lanceolate to linear-lanceolate, 3-4 × 1 mm, apex acute; lateral sepals lanceolate to linear-lanceolate, 3-4 × 1 mm, apex acute; petals slightly reflexed, linear to linear-lanceolate, margins slightly revolute, apex acute; lip sessile, broadly obovate to cuneate, 6-10 × 5-7 mm, base with rounded lobule on each side, apex dilated and deeply cleft into pair of ± divergent broadly rounded lobes, shallowly toothed in sinus; column slightly arcuate, short, 1.5-3 × 1-2 mm. Capsules semierect, ellipsoid, 5 × 3 mm. 2n = 38. Flowering Jun--Jul. Damp humus in shady forests of Appalachian Mountains, often beneath Rhododendron in acidic soil, also in sphagnous thickets and bogs; 600--1300 m; Ga., Ky., Md., N.J., N.C., Pa., S.C., Tenn., Va., W.Va. Listera nipponica Makino, a species similar to L. smallii, occurs in the mountains of Japan.