On July 25, 2019, World Wrestling Entertainment, Inc. (WWE), as a publicly traded company, conducted a conference call to announce its second-quarter fiscal year 2019 results.

[4][5] The inaugural event was originally scheduled to take place on March 25, 2020, at the Prudential Center in Newark, New Jersey,[6][7] but was postponed due to the COVID-19 pandemic.

[8] Over a year later, Blood & Guts was officially rescheduled to air as the May 5, 2021, episode of Dynamite on TNT and be held at Daily's Place in Jacksonville, Florida due to the ongoing pandemic.

[9] The event returned in June 2022 and was held at the Little Caesars Arena in Detroit, Michigan due to AEW's resumption of live touring in July 2021.

[11] Beginning with the 2022 event, Friday Night Rampage - which is usually taped at the same venue Wednesday nights following the Dynamite broadcast - has featured "Royal Rampage", a modified Rumble rules battle royal specifically adapted to accommodate the two-ring setup used for Blood & Guts.

The match features two rings enclosed by a steel cage, which was developed by wrestler Virgil Runnels, better known as "The American Dream" Dusty Rhodes.