The song is named after East Hastings Street in Vancouver's Downtown Eastside.
"East Hastings" begins with a bagpipe reprise of the main theme of the previous track, "The Dead Flag Blues", accompanied by a recording of a street preacher.
The second section, "The Sad Mafioso..." begins with a slow, repeating guitar theme, slowly building as drums and strings are added.
The music becomes faster and more aggressive before switching to double time, ending, and transitioning into the third and final section.
During an interview with The Guardian, 28 Days Later director Danny Boyle explained, "I always try to have a soundtrack in my mind [when creating a film].