This species grows across much of the United States and Canada, in marshes, fens, swamps, ditches, seepage areas and wet fields, and VASCAN lists it from British Columbia to Newfoundland including Quebec. It is the only Eutrochium species found west of the Great Plains. Its flowers draw butterflies and honeybees, and its leaves feed the larvae of several moths.
The species name maculatum means spotted and refers to the purple spots on the stem. The plant was long placed in Eupatorium and is now classified in Eutrochium, with Eupatorium maculatum as its older name. The Greenbelt Indigenous Botanical Survey records it as a companion plant to boneset in Indigenous use.