The initial dark phase of the waxing moon (the nights of Hilo, Hoaka and Kū) was the ideal time to initiate planting. Ancient Hawaiians planted 'uala in pu'e (mounds) or pu'epu'e (high mounding) that formed a māla (patch). 'Uala flourished in forest humus, swamp humus, arid terraces, red soil, decomposed lava, gravelly soil, volcanic cinder or white coral sand mixed with red soil. Only clay was the nemesis of 'uala.

With vigorously sprouted 'uala, the soil surrounding the roots was stirred for several successive days. In dry planting, this was continued until an adequate rain soaking, after which the moist dirt was heaped around the vines anew. In damp areas, the earth was kaiue (softening the soil and pressing around the plants). Olohi'o (weeding) was done in intervals. When vines indicated sturdy growth, they were wiliwili (turned under), each vine being wili (twisted) around its base and firmly covered with pressed soil from the sides of the mounds. This procedure induced the 'uala to concentrate its growing energy into the tubers, rather than running vines.

'Uala was cooked in the imu (underground oven). Peeled and crushed 'uala was blended with water into poi 'uala (sweet potato poi). Mashed 'uala, mixed with coconut milk then baked, was piele 'uala. Young leaves were consumed as nourishing greens, especially for invalids and pregnant women. A severed 'uala vine, exuding milky sap, draped as a neck lei, or used to gently slap the bosom, was believed to promote the flow of milk in a nursing mother. Fermented 'uala produced a beer called 'uala 'awa'awa.

'Uala foliage was superb pig feed. Fishermen used 'uala as palupalu (vegetable bait) to lure 'ōpelu (mackerel scad), into ko'a (offshore breeding areas). Old 'uala vines and leaves were placed under floor mats for padding.

'Uala leaf buds and tubers provided medicinal benefits to Hawaiians. The raw flesh acted as a laxative and purgative. Combined with other ingredients, 'uala was used to treat asthma and shortness of breath, restless sleep, croup, thick phlegm and, as a gargle, sore throat.

'Uala, literally and figuratively, was a monumental icon in the roots of Hawaiian history and culture.