Orthochilus foliosus is found in open grassland of the Eastern Cape, the Free State, KZN, Mpumalanga and Limpopo. Its distribution also includes parts of Swaziland, Zimbabwe and perhaps further afield.
The dense flower cluster appears from spring to autumn during the plants summer growth, the rainy season of its habitat. This habitat is characterised by open, rocky grassland where large stands of the plant in flower may sometimes be seen. The species is not considered to be threatened early in the twenty first century (Pooley, 1998; www.redlist.sanbi.org).