Earleaf false-foxglove grows in dry prairies, fallow (untilled) fields, open dry woods, and the borders of upland forests. The species is either endangered or threatened in nine states, and of an original 16 known Pennsylvania locations, populations can only be found in two areas today. The plant is extremely rare, and historically Earleaf false-foxglove is known to have grown from New Jersey to Minnesota, south to Virginia, Alabama, Tennessee, Arkansas, Oklahoma, and Texas. In Oklahoma, Earleaf false-foxglove was found in Cleveland and Muskogee counties in the 1920s.

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