It was composed over a span of three years (1993–1996) after a commission from the Ensemble Modern—a German music group—to produce a piece for an evening jazz event in 1994.

During this period of composition, Turnage's brother Andrew died of a drug overdose, shaping the music greatly.

Due to this, it has been described as being part of the "third stream" genre, a term coined by Turnage's former teacher Gunther Schuller.

The suite is written as a concerto grosso and features a blend of classical, jazz, non-western and electronic instruments.

The premiere performance of Blood on the Floor was by the Ensemble Modern at the Queen Elizabeth Hall, London, in May 1996.

[6] After the event, Turnage expanded the piece into a nine movement suite; the final composition ended up being a little more than an hour long.

[3] During the composition of Blood on the Floor, Turnage consulted Robertson, John Scofield and Peter Erskine, who would be playing in the jazz trio with the Ensemble Modern.

[8] Blood on the Floor takes inspiration from the paintings of Francis Bacon as with Turnage's previous works, like Three Screaming Popes.

[11] Blood on the Floor reflects Turnage's personal feelings on the death of his brother Andrew,[12] who died of a drug overdose during its composition.

[a] The score calls for a large ripieno consisting of the following instruments:[20] Woodwinds Brass Percussion (two players) Strings

[17] Improvisation forms a major part of Blood on the Floor and appears in four movements (II, V, VI and VIII).

In his 2008 Doctor of Musical Arts thesis, Matthew Styles identifies a total of eight motifs employed that appear in the prologue and reappear throughout the other eight movements.

This melody is played by the bass clarinets and horns, and features a "spinning" cycle of notes based around D♯ and E. It appears in the prologue and returns multiple times in the ninth movement, "Dispelling the Fears".

[31] Chromatic progressions are a major part of the prologue, which along with irregular shaping and metre changes makes the movement have an unrelenting feel.

[34] "Shout" both starts and ends with passages played by the scaffolding, which is used as an unpitched percussion instrument throughout the movement, usually paired with the horns.

"Elegy for Andy" incorporates musical quotations from a piece played by Turnage at his brother's funeral and Giacomo Puccini's Madama Butterfly.

[34] "Cut Up" has a complex structure and has been variously labelled a variation on verse and refrain, rondo and ternary forms.

[33] The movement takes inspiration from Dispelling the Fears, a painting by the Australian artist Heather Betts, and is dedicated to her and her husband Brett Dean.

[55] The suite had its American premiere on 28 September 2001 at the Miller Theatre, New York, performed by the Absolute Ensemble under the baton of Kristjan Järvi.

[58] As the performance was following the events of the September 11 attacks, the concert almost did not take place due to the "provocative" nature of the music.

[58] During his first month as principal conductor of the Berlin Philharmonic, Simon Rattle conducted a performance of Blood on the Floor in October 2002.

[61] Stefan Asbury conducted a Boston Symphony Orchestra performance of Blood on the Floor in the Seiji Ozawa Hall to close the 2006 Tanglewood Festival of Contemporary Music.

[6] On 9 April 2021, the Melbourne Symphony Orchestra performed Blood on the Floor at the Hamer Hall, conducted by Fabian Russel.

This was part of their Metropolis concert series, and featured solo performances from Carl Mackey (saxophone), James Sherlock (guitar) and Dave Beck (drum kit).

[52] The British choreographer Wayne McGregor chose to use Blood on the Floor as the basis for his debut full-length ballet, L'Anatomie de la sensation.

[12] In The Times, Ivan Hewett appraised how Turnage worked with jazz musicians to create a "truly collaborative piece".

Writing for The Daily Telegraph, Richard Wolfson considered Blood on the Floor a "clumsy attempt" at a fusion of classical and jazz music.

[67] Nick Coleman of The Independent agreed, questioning the nature of the work: Is it possible to lose the funk in the bleak architectonics of [Turnage's] formal composition?

Or do we have to take it on trust, because Turnage is interested in "urban alienation" and wrote for American jazzers John Scofield and Peter Erskine in his Francis Bacon-inspired Blood on the Floor suite, that some kind of cold fusion has taken place between the tradition of Miles and Marvin and that of European art music?