This is one of the most primitive of the orchid genera and is closely related to the Epipactis group. The fifteen members of the genus are mainly Eurasian although there is a small presence in North Africa. In Europe the genus is represented by eight species.

The rooting systems of Cephalanthera orchids are non tuberous with extremely fibrous roots and in many ways the underground parts of the plant are very similar to that of Cypripedium. The  single stigma produces sticky pollen which is attractive to insects but the means of vegatative propagation is one of its primitive ancestral characteristics.

Flowers are virtually or completely stalkless, being held on upward pointing, spirally twisted ovaries.