The twoleaf miterwort has a single erect stalk with a pair of sessile maple-like leaves midway up, plus additional basal leaves. The plant can reach a height of 10 to 18 inches. It is most often found in soil that is rich in organic material, but it can tolerate moist, rocky soil. It blooms late enough to demonstrate that it is shade tolerant under the canopy of forest trees. The plant’s single, slender, elongated flower cluster contains a row of beautifully fringed white flowers, each only about ⅛ inch in diameter. Each individual flower, when examined closely, resembles a snowflake. The flowers are spaced widely on the stem and face in different directions. Each flower has five petals, ten stamens and a single pistil. Gnats, flies and small bees are attracted to the tiny flowers - the flowers are too small for large pollinators to land.

The flowers are found above each pair of leaves at the middle of the stem. The leaves are usually 3 lobed. The plant is named for its fruit, a capsule that has the shape of a bishop's miter or hat. The plant self-sows after the capsules open, exposing the small black seeds to the splash of raindrops which then disperse the tiny seeds. The plant can also form clumps asexually by generating new stems from the rhizome. The species is found in Eastern North America from Quebec to Georgia in the mountains. The twoleaf miterwort has been documented in all Pennsylvania counties.  Miterwort is sometimes grown as an ornamental plant in shade gardens.

The Menominee used the seeds as sacred items in medicine dances and the Iroquois used the whole plant to make medication for the eyes as well as a good-luck charm.