Written by Usher, Dupri and Cox, the song is a confession of a man to his woman about his impregnated mistress.

Its personal content evoked rumors and early responses from the public even before its release, believing that Usher was asserting the truth; however, Dupri divulged that the story behind the album is about himself.

Like "Burn", the second single from the album, Dupri and Cox conversed about a situation, creating the idea of the prospective song.

One day, before the night was over, Usher was singing about impregnating a mistress and becoming displeased, having found that she is three months pregnant.

[7][8] In the United Kingdom, it was issued as a double A-side with "My Boo", the fourth single from the album in other territories.

[10] Shortly after, people came up with different interpretations of "Confessions Part II", among other personal songs in the album.

In 2003, Usher's two-year relationship with TLC's Chilli was going to "flame-out", which partly contributed to the concept of "Burn".

[10] They finally broke up early in 2004 because of "irreconcilable differences and because the two found it almost impossible to make compromises" which partly triggered public speculation that some of the songs in the album are in reference to his personal struggle.

[2][11] Alongside the "cheating" rumors, the public inferred from the lyrics that Usher had impregnated a mistress in real life.

He stated, "me cheating on my steady girlfriend, having a baby with that other woman and having to confess to everything that happened to my main girl.

"[10] Behind rumors, Usher refuted in an interview with MTV News: People assume things, because as I said, I pull from my personal experiences to make my music ...

I never experienced [fathering a child outside of a relationship] firsthand, but it's something I wanted to talk about  ... and it's something that has happened to me in the past ... As I said, I have a few deep, dark ones that I've kept stowed away in a closet for a minute ... That's why I take this time to speak to you guys and let you know really what it is ...

[15] Laura Sinagra of Rolling Stone focuses on how Usher admits in the song about impregnating a mistress.

[17] Outside of rumors, Jem Aswad of Entertainment Weekly said that the best songs from the album were "Confessions Part II" and "Burn", which he described as having smooth melodies.

[22] It peaked at number one on July 27, 2004, replacing "Burn"'s eighth non-consecutive chart run,[23] and stayed there for two weeks.

[24] The single was certified three-times platinum by the Recording Industry Association of America on for reaching 3 million shipments.

The single debuted at number five in Australia, becoming its highest entry, and failed to reach a higher position.

Alone, Usher stands in front of a wide mirror, which breaks into pieces accompanied by a roaring sound, ending the same way "Confessions Part II" started, with him sitting on a chair.

The music video features actresses Angell Conwell and Robinne Lee as Usher's two love interests, as mentioned in the song.

The song is also parodied by "Weird Al" Yankovic on his album Straight Outta Lynwood (2006) as "Confessions Part III", and features the singer confessing more minor or ridiculous actions, such as borrowing his partner's nose-hair trimmer or returning a gift from her for store credit.