The episode was written by Andy Bayliss and directed by David Innes Edwards, and it premiered on BBC One on 22 March 2022.
The episode's main story is Jac Naylor's (Rosie Marcel) operation to remove a brain tumour.
Other stories featured included Josh Hudson's (Trieve Blackwood-Cambridge) bulimia and guest character Ken Davies' (Hamish Clarke) admission to AAU ward.
The episode also features Holby City's final location shoot which was filmed solely with (Bob Barrett) as Sacha Levy.
Max McGerry (Jo Martin), Madge Britton (Clare Burt) and Henrik Hanssen (Guy Henry) discuss Jac Naylor's (Rosie Marcel) upcoming operation.
Elliot Hope (Paul Bradley) informs them that her latest scan results indicate more tumour growth which will make the procedure even more difficult.
Sacha Levy (Bob Barrett) clashes with Adrian "Fletch" Fletcher (Alex Walkinshaw) over doubts about Jac's operation.
Josh goes to confront Anita but finds Ken Davies (Hamish Clarke) outside the hospital with injured legs and Dominic Copeland (David Ames) rushes to assist him.
Alexandra 'Lexy' Dunblane (Jenny Howe) is treated on Keller by Donna Jackson (Jaye Jacobs), Jeong-Soo Han (Chan Woo Lim) and Henrik.
"[3] Despite this, the BBC made a commitment to work with the Holby City production team to ensure that the show ended "on a high".
[2] Viewers of the show launched a Change.org petition to save Holby City, which gained more than 30,000 signatures in the immediate weeks following the cancellation,[4] and by December 2021 it reached 43,700.
[7] Most of the stories featured in the episode were written to create a "satisfying conclusion" with the show's finale in mind.
"[8] Writers chose to feature Jac Naylor's (Rosie Marcel) brain tumour surgery as the episode 1101's main story.
It features returning character Elliot Hope (Paul Bradley) determined to find a solution and cure Jac's cancer.
[9][10] They also included other stories centric to Josh Hudson (Trieve Blackwood-Cambridge) and guest character Ken Davies (Hamish Clarke).
Marcel added that the cast and crew were spurred on by the BBC's decision to end the show and "we've delivered something outstanding".
[12] In one scene, Sacha Levy (Bob Barrett) chases Jac into the hospital lift begging her to reconsider her operation.
Wadey told Kitson that the scene made "compelling drama" because "that clarity of view" Jac has and her determination to fight for her life.
[13] Guest cast members for the episode included Jenny Howe as Alexandra 'Lexy' Dunblane Lucy and Briggs-Owen as Amelia Ebrahimi.
[11] A member of the show's production team told Elaine Reilly from Whattowatch.com that "there is no strong specificity to the track, it was selected as a song that might likely be a record her dad had and played to Jac when younger.
[18] Advance written spoilers and photographs were also released ahead of the broadcast but the outcomes of Jac's operation was kept under embargo.
Reilly added that Holby City has traditionally been a "central hub for miracles" and hoped Jac would be cured the following episode.
[25] Writing for Whattowatch.com, Reilly stated "the popular medical drama isn’t going out quietly" because it had "big emotional punches".
She added "their storyline has been one of the show’s strongest final arcs, a testament to both actors who only had a matter of months to develop their characters.
"[31] Their colleague Sue Haasler branded it a "hugely emotional episode" and Jac's requesting Elliot let her die an "heartbreaking promise".