[5] Author and co-creator of the Dragonlance campaign setting Tracy Hickman distributed an angry response to Dragon 300 in a mailing-list newsletter entitled "D20 Terrorism".

Following repeated references to the Comic Book Code, he stated, "Every dark fear that mothers and clergy across America have about D&D is now, suddenly, true.

Game designer Dale Donovan noted in Pyramid: "The fact that both the 300th issue of Dragon and issue #95 of Dungeon had sealed, "mature content" sections incited more than one Internet flame war, with lots of folks flying off the handle in this direction or that, numerous invectives being tossed back and forth like hot potatoes, and scores of teeth gnashed for one reason or another.

"[8] Book of Vile Darkness introduced several new mechanics relating to evil in Dungeons & Dragons, including rules for drug use, demonic possession, torture, and ritual sacrifice.

The cover art was created by Henry Higginbotham, with interior art by Daren Bader, Thomas Baxa, Matt Cavotta, Brian Despain, Jeff Easley, Scott Fischer, Lars Grant-West, Quinton Hoover, Jeremy Jarvis, Raven Mimura, Vinod Rams, Wayne Reynolds, David Roach, Richard Sardinha, Brian Snoddy, Arnie Swekel, and Anthony Waters.

"Overall," Gustafson wrote in August 2003, "Book of Vile Darkness is quite possibly the best supplement that Wizards of the Coast has put out in recent memory.

Rules for drug use had, in fact, already been printed,[15] while later material included corrupt spells,[16] vile feats,[16] possession,[17] and detailed discussions of demon lords.

[19] For the fifth edition, the Dungeon Master's Guide lists the book as an artifact rarity wonderous item, penned by the lich-god Vecna.