Sweet Betsy, like all trilliums, belongs to the bunchflower family (Melanthiaceae). It is the largest of the eastern sessile trilliums, with a wide range and striking color variations that led botanists to historically classify many less common trilliums as forms of this species. In spite of its appearance, sweet Betsy produces no true leaves or stems. Its "stem" is actually a scape - an unbranched extension of the rhizome, and its three "leaves" are bracts - leaf-like structures that perform photosynthesis but arise directly from the scape.

This plant prefers limestone-rich soils and is most commonly found in rich upland woods. Flowering from April to early May, it produces a sessile maroon flower that emits a strong, meat-like odor, earning it regional nicknames like "bloody butcher." This scent attracts flies, which likely assist in pollination.