"The American Ruse" attacks what the Detroit quintet saw as the hypocritical idea of freedom espoused by the US government, and "The Human Being Lawnmower" expresses opposition to the US involvement in the Vietnam War.

The last song on the album, which is the title track, is a cover of Chuck Berry's 1959 single "Back in the U.S.A." Reviewing Back in the USA for Rolling Stone in 1970, Greil Marcus admired the album's "attempt to define themes and problems and an offering of political, social, and emotional solutions", but found that "the music, the sound, and in the end the care with which these themes have been shaped drags it down, save for two or three fine numbers that deserve to be played on every jukebox in the land".

In his retrospective review, Jason Ankeny of AllMusic wrote, "While lacking the monumental impact of Kick Out the Jams, the MC5's second album is in many regards their best and most influential".

– Lemmy, Motörhead[8]In 2012, Back in the USA was ranked number 446 on Rolling Stone's list of the 500 greatest albums of all time.

[10] Jason Ankeny of AllMusic commented that "[the album's] lean, edgy sound anticipat[ed] the emergence of both the punk and power pop movements to follow later in the decade.