It is their first release with longtime member Frank Watkins on bass, and also their first and only album with guitarist James Murphy, previously of Death.

Murphy did not contribute to the songwriting as the riffs he showed to the band would end up appearing on Disincarnate's Dreams of the Carrion Kind.

Monte Conner of Roadrunner forced Sepultura to use another Michael Whelan illustration for Beneath the Remains, Nightmare in Red.

[4] Obituary went on tour in the United States to support Cause of Death in November 1990 together with label mates Sepultura as headliner and Sadus, starting in Florida.

said, "On their sophomore effort, [Obituary’s] hard work and patience paid off in the form of one of the most gut-wrenching, joint-twisting albums ever written.