She created an unnamed alter ego after she discovered Butters' "Gay Little Costume".
Grandma Stotch wears dark green pants, a pink shirt, a green and white hooded jacket, and dark green earrings. She has short white, hair and is visibly aged.
Although she pretended to be kind and loving in front of other people, she was very cruel and sadistic towards Butters and enjoyed hurting him. She liked to make him suffer and often injured him, stole his lunch money, threatened him, and gave him "gummy bears" (putting a part of his body in her toothless mouth). She appears to "change" after Butters tells her that someday she will die and he will keep living, likely making her cruelty temporary.
- She may be from Virginia, as Butters mentioned that one of his grandmothers lived in Virginia in "Reverse Cowgirl".
- It is unknown if she is Butters' maternal or paternal grandmother, however, the first is more likely since she was talking to Linda about her cousin in the beginning of "Butterballs".
- She may have suffered a stroke in "Freak Strike" as during the episode Stephen Stotch tells Butters that one of his grandmothers had a stroke from seeing him on Maury Povich with balls on his chin.
- She is shown to be just as much of a bully as Butters' parents, who ground and beat him often for no good reason.
- It might be possible that the reason Butters' parents are so cruel to Butters is that they might have been raised in an awful environment by Grandma Stotch.
- "Butters' Very Own Episode" (mentioned only)
- "Freak Strike" (mentioned only)
- "Margaritaville" (mentioned only)
- "Reverse Cowgirl" (mentioned only)
- "Butterballs" - First appearance. Seen bullying Butters.