The tree is deciduous, growing up to 20 feet high. It is very hardy, growing in cold climates to USDA zone 6. It is easy to grow and does well in average soil but prefers well-drained moisture retentive loamy soil in an environment with full sun. It will grow in part shade but the fruit yield and quality will be considerably lower. Once established, it is drought tolerant. Young seedling trees take from 5 – 8 years before they start bearing fruit, though grafted trees will often flower heavily in their third year.

Propagation is best done by seed sown in the fall as soon as it is ripe. Stored seed germinates slowly and erratically, and though some may germinate in the spring, most seed takes another year. It should be warm stratified for 3 months, and then cold stratified for another 3 months, and it may still take another 18 months to germinate.

In order to help seeds germinate more quickly, they may be scarified before stratifying, or some recommend soaking the seed for a few days in its own pulp. When seedlings are large enough to handle they should be planted in individual pots for their first year, then planted outside in a permanent place in late spring.

The hawthorne tree bears 1 1/2 inch fruits that are harvested after ripening in September. For medicinal use, good quality Shan Zha consists of large red or reddish brown fruit with fleshy pulp. Fruit with a sour, tart taste are considered best.

Hawthorne trees are commonly grown in North America as ornamental plants, particularly for their bright red fruits and shiny foliage. Native to Korea and northern China, Crataegus pinnatifida is grown specifically for its edible fruit. The sub-species C. pinnatifida major has larger fruit than the type species and is the main cultivar grown for hawthorne fruit in China. The fruit is used in Chinese medicine preparations and is also eaten raw or sweetened. It is a popular treat called “tang hu lu” or “tang qiu” when the fruits are candied and strung five on a bamboo stick. Hawthorne fruit is also available as a jam (shan zha gao) or in thin sheets of dried fruit (shan zha pian).

Traditionally, Shan Zha is used as an herb to promote digestion, but beginning in 1960 many studies were published showing its positive effects on lowering blood pressure and cholesterol. It is now included in many preparations recommended for promoting digestion, improving appetite and lowering blood pressure and cholesterol. In one common recipe, 4 ounces Shan Zha (hawthorne fruit), 4 ounces Gu Ya (sprouted rice), 4 ounces Mai Ya (sprouted barley), and 1 1/2 cups sugar are simmered in 8 cups of water until the ingredients break down into a thin paste. The paste is strained out and a teaspoon added to hot water to make a drink taken twice a day in place of coffee or tea.