Plants 23-60 cm. Stems: sheaths 5-9, cauline, bladeless. Leaves 2-7; petiole not distinct; blade elliptic, 5-25(-35) × 2-8 cm. Inflorescences 3-18 cm; rachis pubescent with bubble-shaped, glandular-capitate, and transitional hairs; floral bracts lanceolate. Flowers usually orange-red, occasionally pale green or golden bronze; dorsal sepal free, lanceolate, ascending at apex; lateral sepals basally connate, lanceolate, decurrent along lateral ribs of ovary; petals lanceolate, falcate, slightly decurrent basally; lip lanceolate, base sessile, grooved, apex acute to acuminate, with linear, nearly marginal, pubescent calli near base; anther cap 6-7 mm. Capsules ascending, ovoid, expanded portion 9-16 × 6-10 mm. Seeds 0.5-1.4 mm.

In Florida the two varieties differ in their breeding systems, Sacoila lanceolata var. lanceolata producing seed by adventitious embryony and var. paludicola by auto-pollination (P. M. Catling 1987). Plants of this species from Florida, referred to Spiranthes lanceolata var. luteoalba (Reichenbach) Luer (C. A. Luer 1972), represent only a very restricted clone with more ascending flowers whose characters intergrade with those of plants from other parts of the range. Because all green-flowered plants addressed by Luer do not consistently possess the distinctive features he noted and do not conform to the description of var. luteoalba (Reichenbach f.) Luer, they are best recognized at the rank of forma as forma albidaviridis Catling & Sheviak (P. M. Catling and C. J. Sheviak 1993).

Sacoila lanceolata is widespread in tropical and subtropical America. Synonyms for Sacoila lanceolata in the restricted sense are given by L. A. Garay (1980[1982]) and in the very broad sense by C. A. Luer (1972). Two color forms associated with var. lanceolata have been named: forma albidaviridis Catling & Sheviak, with green and white flowers, and forma folsomii P. M. Brown with golden bronze flowers.