Bistorta bistortoides grows from foothills to above the timberline, although plants growing above 7,500 feet (2250 m) are smaller and seldom reach more than 12 inches (30 cm) in height. Plants in other areas may reach over half a meter-1.5 feet (20-60 cm) tall. The leaves are leathery and up to 40 centimeters (3 feet) long, and are mostly basal on the stem. The dense cylindrical to oblong inflorescence is packed with small white to pinkish flowers, each a few millimeters wide and with protruding stamens.
American bistort was an important food plant used by Native Americans living in the Mountain West, and the roots are edible either raw or fire-roasted with a flavor resembling chestnuts. The seeds can be dried and ground into flour and used to make bread. They were also roasted and eaten as a cracked grain.