The reproductive cycle begins when the male Carolina heelsplitter releases its sperm into the stream. Soon afterwards the sperm is taken in by the females, a process which is called siphoning. The female's eggs, which will be carried in the females gills, are then fertilized. When the glochidia (larvae) are fully developed, the female mussel releases them into the water. The larvae must attach themselves quickly to a body part of their host fish, which is not harmed in the process. The host fish species for this mussel is still unknown.