[10] Achy Breaky Heart was written by amateur songwriter Don Von Tress from Cypress Inn, Tennessee, in 1990, according to him "just fooling around on the guitar and a drum machine".

Billy Ray Cyrus heard Von Tress's version of the song, and chose to include it on his debut album Some Gave All in 1992.

Considine from The Baltimore Sun wrote, "It would be hard to think of a more perfect example of how contemporary country has co-opted the sound of rock 'n' roll than Billy Ray Cyrus's single, "Achy Breaky Heart".

Between the down-home twang of the vocal and the foot-tapping insistence of the boogie guitar licks, it has no trouble walking the line between Southern rock and Nashville sentimentality.

[19] Members of the Muscle Shoals Rhythm Section participated in the recording Rolling Stone called "more faithful to songwriter Don Von Tress's swampy demo.

While Cyrus does never explicitly say the song is a parody, the lyrics and accompanying video clearly make several references to daughter Miley's bad-girl image at the time, with Billy Ray noting in a Rolling Stone article that he "[hopes] that she got to read the one critic who wrote that the video made her performance at the VMAs look like Sesame Street".

[25] A mixed language (English and Spanish) duet version by Cyrus and Caballo Dorado celebrated the 25th anniversary of the song in 2017.

[28] Supporters of many UK football clubs have used chants based on the tune of the song, including West Ham United (about Dimitri Payet), Arsenal F.C.

[32] It has also been adapted as "Don't Take Me Home", which has been sung by the supporters of several national football teams, including England, Wales, the Republic of Ireland and Sweden.

The chant was particularly associated with Wales's run to the semi-finals of UEFA Euro 2016,[33] and lent its name to Don't Take Me Home, a documentary film about the team's performances at that tournament.

Cyrus's version of the song spent five weeks at the top of the Billboard Hot Country Singles & Tracks chart in 1992.

This was the longest time spent at the top of that chart by a debut single since "Skip a Rope" by Henson Cargill in 1967 and the last until "Austin" by Blake Shelton in 2001.