Foam flower typically grows in cool, shaded habitats, often in maple stands and mixed forests. It thrives in rich, well-drained, slightly acidic soils beneath mature trees.
This species is strictly native to North America, although other Tiarella species occur elsewhere in the world. Widespread in the United States, it is especially common along the East Coast, in the Appalachian region, and in northern states such as New York and Pennsylvania, as well as farther south (North Carolina, Georgia, and Tennessee).
In Canada, foam flower is found in the southern part of the country and in the Maritimes. In Québec, it occurs mainly in the southern areas of the province, including the Cantons-de-l’Est, the Montérégie, the Lanaudière, the Laurentians, and the Mauricie regions.