The song's theme centers around the resilience of Allentown, Pennsylvania and the surrounding Lehigh Valley region of eastern Pennsylvania in the 1980s as it coped with the decline of its historically strong manufacturing sector and its emergence as a part of the Rust Belt in the latter part of the 20th century, including the depressed, blue-collar livelihood of Allentown residents following the decline and eventual closure of Bethlehem Steel, which was the world's second-largest steel manufacturer for most of the 20th century.

[1] The introductory rhythm for the song is designed to be the sound of a rolling mill converting steel ingots into I-beams or other shapes.

Joel remembered reading about the decline of the steel industry in the Lehigh Valley, which includes the cities of both Bethlehem and Allentown.

In November 1982, Cashbox wrote that, "The melody is a great deal more upbeat than the lyrics would indicate, but the message comes through nonetheless.

On December 27, 1982, Joel played before a sold-out crowd at Stabler Arena in neighboring Bethlehem.

He opened and closed his set at Stabler Arena with "Allentown," receiving a five-minute standing ovation following its second performance.

"[9] The video, directed by Russell Mulcahy and featuring choreography by Kenny Ortega, was in heavy rotation on MTV throughout 1982 and 1983.