A concept album, American Doll Posse sees Amos assuming the identity of five different female personalities inspired by Greek mythology in order to narrate stories of life in modern America.

Themes include opposition to the Iraq War, recording industry misogyny, disillusionment, sexuality, personal loss, and female empowerment in general.

Musically, the record is more rock-oriented than other studio works by Amos, notably featuring more guitar and drums than previous albums The Beekeeper (2005) and Scarlet's Walk (2002).

[5]While early press indicated that Amos may bring back both the harpsichord (last used on Boys for Pele) and the Wurlitzer (used on Strange Little Girls and Scarlet's Walk),[6] only the latter appeared on the album, on the track "Dark Side of the Sun".

The deluxe edition includes two videos (a behind-the-scenes of her photo shoot and a slideshow-style bonus track titled "My Posse Can Do"), an expanded booklet, and five postcards, one of each "doll".

Amos offered detailed descriptions on the five personalities, explaining the attributes that each represented, which Greek goddess was the inspiration, and what songs on the album each "doll" provided the narrative for.

"My Posse Can Do" is included on the DVD accompanying limited-edition versions of the album, while the tracks "Miracle" and "Drive All Night" were available exclusively through the iTunes Store and Borders, respectively, as digital downloads for a limited time.

[15] During her virtual book tour on May 7, 2020, Tori revealed that additional songs written for the album, some of which were demoed, include: "Christmas in July [Santa]", "Inhale", "The Lucy" (part of which became the bridge in "Edge of the Moon" on 2011's Night of Hunters), "Femme Fatale", "Shoot That Arrow" (which dated back fifteen years then), "Shame About Kate" (previously known as "Inside Job"), "Crystalline" (which later became "Reindeer King" on 2017's Native Invader), "Hi Ho Silver", and "Mermaids".

Amos, using a Bosendorfer piano, Yamaha synth, and Hammond organ, was backed by Matt Chamberlain (drums), Jon Evans (bass), and Dan Phelps (guitar).

[citation needed] For the first time in Amos's career, no official music videos were produced by the artist for any of the singles from the album, although a clip featuring still images from the record's promotional shoot was issued as an accompaniment to "Big Wheel".

For "Bouncing Off Clouds", clips of Amos singing and playing the piano against a neutral background were released and encouraged fans to edit their own music videos as a competition.

[citation needed] American Doll Posse was met with generally favourable reviews, with most criticism being directed not at the musical content but towards the extensive concept as a potential turn-off for casual listeners.

[36] The review from PopMatters was very positive, with an 8/10 score, praising Amos' assured vocals as "top form" and finding "moments of jaw-dropping virtuosity", but also criticising the length of the album and lack of editing.

[37] SPIN gave a glowing review, giving the record a 9/10 score, calling it "arguably the singer/pianist's greatest, and undeniably sexiest, album" and "instantly memorable".

[38] Entertainment Weekly gave the album a C+ review, calling it a "conceptual wreck" but appreciating the freshness of Amos engaging in glam rock territory.

[40] Slant Magazine gave American Doll Posse 3.5 of 5 stars, criticising the structure as alienating but finding the music itself to be Amos' best since From the Choirgirl Hotel (1998), especially favoring the lead single "Big Wheel" as a straightforward and lively song.

[44] In the United Kingdom, limited-edition copies of the album were ruled to be ineligible for the UK Top 40 chart due to the inclusion of free art cards depicting each of the Posse members.

Faced with this, Amos deliberately chose not to issue a reduced packaging version of the special edition (as had been done with Scarlet's Walk), opting to keep the artwork intact.