The album's cover art, composed by Alton Kelly and Stanley Mouse, is based on an illustration by Edmund Joseph Sullivan for an old edition of the Rubaiyat of Omar Khayyam.

[4] Though the album has been known by the sobriquet "Skull & Roses", the original vertical gatefold cover unfolds to reveal the entire skeleton.

The CD includes a bonus disc of songs recorded live at the Fillmore West in San Francisco on July 2, 1971.

[6] When the band submitted "Skull Fuck" (a contemporary euphemism for "blow your mind") as the album title, it was rejected by the record label.

Drummer Bill Kreutzmann explained the lack of a title on the artwork and labels, "...the original name was going to be "Skull Fuck".

This was a time long before rap artists like Eminem numbed concerned citizens to the idea of offensive language in music.