This species' habitat and ecology at Koh Tao Island, the only confirmed part of its distribution, is unknown. All information herein is based on populations assigned to this species from outside Koh Tao Island. Individuals are known from a variety of habitats including subtropical or tropical moist lowland forests, montane forests, rivers, intermittent rivers, swamps, freshwater marshes, intermittent freshwater marshes, plantations, rural gardens, urban areas, heavily degraded former forests, irrigated land, and seasonally flooded agricultural land. In the dry season most have been observed in moist meadows, swamps, or open secondary forests. In the rainy season individuals are predominantly found in open pasture, gallery forests, open bush and secondary forest (Dunker et al. 2000). The species is associated with strongly acidic soil (Dunker et al. 2000). Mating is believed to be triggered by the monsoon season (Kupfer et al. 2005). Parts of the species' range are disturbed by agriculture (Sodhi et al. 2009), however the effect of this on its population is not clear.

Individuals tentatively assigned to Ichthyophis kohtaoensis reach a somewhat larger size than other known Thai species, the largest known measuring 350 mm in length. It is believed through both field and laboratory studies that females first breed when they are three years old. It has terrestrial eggs, laid in a burrow on land, and aquatic larvae (Kupfer et al. 2005). The average clutch size as observed in the Mekong Valley is 32-58 eggs (Kupfer et al. 2006). The species’ maximum longevity is 7.3 years (in captivity).

This species is only known with certainty from Koa Tao Island, Thailand (Taylor 1960). There are also records from Peninsular Malaysia, through the peninsula including other Thai islands (Nishikawa et al. 2012) to southern Myanmar (Mulcahy et al. 2018) and into southern Lao People's Democratic Republic (Teynié et al. 2004) and northern Cambodia (Stuart et al. 2006). However, most records outside of Koa Tao Island were only tentatively assigned to this species (Teynié et al. 2004, Nishikawa et al. 2012, Mulcahy et al. 2018) and a revision of the taxonomy of striped caecilians in Southeast Asia is needed before records can be confidently identified to species level (Nishikawa et al. 2012). These areas have been included in the range map associated with this assessment as areas where the species is presence uncertain. Additional records from China and Viet Nam should be assigned to Ichthyophis bannanicus and Ichthyophis nguyenorum, respectively (T. Nguyen pers. comm. October 2013). The species' elevation range is unknown.