Insects are attracted by the putrid odour of the flowers where they are then deceived to lay eggs. Mainly flies, but also other insects, are responsible for pollination. Reese (1973) gives an overview of the highly specialized flowers and the pollination process in the Stapeliae, which are very similar to this group.

At a distance, insects are primarily attracted by the foul-smelling nectar. Closer to the flowers the coloration and moving hairs are responsible for secondary attraction. The pollen is packed into two joined units called pollinaria (the structure as a whole is known as the pollinium). In the platvoetaasblom the pollinia are loosely attached and are deposited onto the insect (usually its proboscis) when it searches for nectar or a suitable place to lay its eggs. The pollinia are then carried to another flower as the insect moves between flowers.

In general, because of the specialized pollination syndrome, fertilization has a low percentage of success. However, large quantities of seed are produced per fruit.

In Brachystelma barberae, the fruit has an after-ripening period, usually until spring about a year after fertilization. The pedicel thickens as it provides nourishment for the growing fruit and seed. Mature fruit bursts open lengthwise. The seeds are adapted to wind dispersal; each one has a tuft of white hairs opening into a parachute-like structure when dry, helping it to be carried off for dispersal by the slightest breeze. As the seed with its tuft of hairs dries off after it has been released, the two structures become detached and the seed germinates and starts growing, if it has landed in a favourable spot.

The size of the tubers is related to the age of the plant. The age of one of about 200 mm diameter is likely to be 10 to 20 years and it is also likely to be considerably tougher. The tuber is a storage organ for both food and water. In autumn plants lose their leaves and go into a dormant state until the next spring.