Bouton co-created the show with humorist and television critic Marvin Kitman and sportswriter Vic Ziegel.

[1] Ball Four followed the Washington Americans, a fictitious minor league baseball team, dealing with the fallout from a series of Sports Illustrated articles written by Americans player Jim Barton (Bouton).

[2] Like the book, the series covered controversial subjects including womanizing players, drug use, homosexuality in sports, and religion.

Consequently, the writers had some trouble with the network's Standards and Practices in their attempt to portray realistic locker room scenes, especially the language used by the players.

While Bouton and other members of the cast received praise for their performances, critics found the series uneven in quality.