The slow growing Koki'oke'oke'o will remain a shrub for many years before becoming a small tree.The leaves are smooth and narrow to broad heart-shaped. The white flowers are fragrant and have a bright red stamen, they open around midday and close in a day.The koki'okeoke'o requires full sun and can grow well in coastal areas. If it is pruned it can be a hedge. It requires moderate watering and needs little care.

Ancient Hawaiians referred to this flower in several ancient stories and chants. The buds of the white hibiscus made a mild, pleasant tasting laxative and the fiber was used for cordage and tying.