Fully flowered plants can grow to 50 cm tall and have up to 12 strap-shaped, keeled leaves with pointed tips that are bunched closer to the ground. The plants have two small ovoid tubers. The epithet pyramidalis characterises only the newly blossoming inflorescence in contrast to the later stages, when the blossom is less conical and more oval and domed. The flowers have a very long and thin spur that is tapering towards its end; however, there are local colonies that have relatively short spurs. The lip, ends as a rule, as three pointed and elongated lobes. At the base of the lip are two upright calluses (ridges) found, either side of the spur entrance. The top sepal and petals form a helmet like hood over the column, the lateral sepals extend sideways horizontally and are a little bigger than the top sepal. As a rule, the colour of the flowers is vividly pink to carmine, however the colour is also highly variable. The two pollinaria have a common viscidium.
In late autumn, the daughter's tubers develop small shoots that form a new rosette of leaves from which leaves and a flower spike will rise in the spring. The period of bloom is from full spring to the early summer; the autogamous flowers are visited and pollinated by many different insects. In the southern-most part of the distribution area (e.g. on Cyprus), blossoming plants were observed near sea level at the end of February, whereas very far to the north (e.g. in Ireland) or in alpine biotopes, the plants blossom until August. One month after flowering the maturation of the seeds starts and the percentage of flowers setting seed is normally very high.
In Central Europe the species settles in open sunny areas on soil rich in bases, with a predilection to mountainous and extensive high valley meadows. In Southern Europe it is often found in coastal regions especially in areas of degenerated shrub, such as phrygana, but especially in tall thorn shrubs. It has revealed an astonishing ecological width and adaptation, for example in Ireland, it settles in small mossy areas of coastal dunes and damp places that originate from watercourses that formed the dunes. Within these rather hostile-to-life biotopes it appears in a dwarfish form; even similar high alpine adaptations are also noteworthy.
This species settles from sea level to heights of more than 2,300 m. The vast distribution area reaches from North Africa through western and Central Europe along the Atlantic coast to the Hebrides and northern outposts exist on some Baltic islands. To the east, it is extremely likely that the influence of the increasing continental climate has prevented further propagation. To the south-east it remains close to the coasts of the Levant, while it reaches the Caucasians south of the Caspian Sea via the high mountains of northern Turkey.