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This hardy plant reaches on average 10–25 centimetres (3.9–9.8 in) of height, with a maximum of 60 centimetres (24 in). The stem is erect and unbranched. The basal leaves are linear-lanceolate with parallel venation, up to 25 centimetres (9.8 in) long, the cauline ones are shorter and barely visible on the stem. The arrangement of hermaphroditic flowers in a compact pyramidal shape is very distinctive and gives the orchid its common name. The colour of the flower varies from pink to purple, or rarely white, and the scent is described as "foxy". The flowers have six tepals, being three small sepals and three petals. Two small petals are on the sides, while the third and lower (labellum) is large and bilobate. At the back of the flower there is a tubular spur of about 1.5 centimetres (0.59 in) long, while the labellum bears two lateral small flaps.
Anacamptis pyramidalis requires a sunny spot on diverse soils: loamy or clay. It can even grow on very alkaline soil. It can be found on meadows or dry and well exposed slopes, at an altitude of 0–2,000 metres (0–6,562 ft) above sea level.