Betula occidentalis odorless when scraped. The leaves are alternate, ovate to rhombic, long and broad, with a serrated margin and two to six pairs of veins, and a short petiole up to long. The flowers are wind-pollinated catkins long, the male catkins pendulous, the female catkins erect. The fruit is long and broad, composed of numerous tiny winged seeds packed between the catkin bracts. The identity of similar birches in Alaska is disputed; some include them in "B. occidentalis", while others regard them as hybrids between "Betula neoalaskana" and "Betula glandulosa". Some Plateau Indian tribes used water birch to treat pimples and
Beech bark disease to spread to the south and west. The first case of beech bark disease in the United States was reported in 1929 in Massachusetts. By 2004, the disease had spread as far west as Michigan and as far south as western North Carolina. For beech bark disease to occur, two components are required, an insect and a fungus. The beech scale insect, "Cryptococcus fagisuga", is invasive to North America and is host-specific, feeding exclusively on beech trees. It can be observed on the trunk and limbs of the tree as woolly, white tufts that will later develop into broad strips.