Paper birch in the Inland Northwest has received little scientific attention despite its emerging recognition as a key factor in forest health and diversity. It has diminished as a natural forest component due to fire suppression and management discrimination, and only recently has caught the attention of product manufacturers. Its ecological range and uniqueness generates wide interest but there is little information to support economic development or provide management guidance. Previous regional experiences with red alder, another “orphan” species, indicate that birch has potential for economic development. Research on birch root biology and field observations indicate an important role in forest health and productivity. Recent findings of Canadian researchers show that paper birch has a fascinating relationship with Douglas-fir, transferring carbon (food-sugar) through mycorrhizal connections, and producing anti-biotic compounds that resist and repel several fungi that cause conifer root-rot. Basal area carrying capacities are increased where birch and conifers are mixed. Field observations indicate that birch thrives on “bad rock” conifer sites. In addition to diverse, conventional wood products, birch is also used for syrup and pharmaceuticals including new cancer-fighting compounds from the bark. These and other ecological and economic aspects of paper birch in the Inland Northwest face several obstacles including “conifercentric” thinking, inadequate inventory information, introduced pathogens, and scientific neglect.