Fresh and dried shiitake have many uses in the cuisines of East Asia. In Chinese cuisine, they are often sauteed in vegetarian dishes such as Buddha's delight. In Japan, they are served in miso soup, used as the basis for a kind of vegetarian dashi, and also as an ingredient in many steamed and simmered dishes. In Thailand, they may be served either fried or steamed.

Shiitake are often dried and sold as preserved food in packages. These must be rehydrated by soaking in water before using. Many people prefer dried shiitake to fresh, considering that the sun-drying process draws out the umami flavour from the dried mushrooms by breaking down proteins into amino acids and transforms ergosterol to vitamin D. The stems of shiitake are rarely used in Japanese and other cuisines, primarily because the stems are harder and take longer to cook than the soft fleshy caps. The highest grade of shiitake are called donko in Japanese.

The Shiitake mushroom has been cultivated since 960 A.D. in China. Shiitake grows naturally in Japan, Korea, and China on dying broadleaf trees. Shiitake Fruits readily from 50-80 F from hardwood logs or stumps, or from sterilized supplemented sawdust blocks. The medicinal benefits are solidly documented. An extract from Shiitake, known as Lentinan, is approved as an anti-cancer drug in Japan. In lab studies, Lentinan completely stopped the growth of a tumor known as Sarcoma 180. As a bonus, it is a delicious treat to eat. The flavor is meaty yet earthy, and shiitakes go great in soups, stir fry, salads, as a main meat substitute or a side dish. Grilled, sautéed, broiled, or fried, this is one mushroom you must try.