Among other collaborators, the album features three longtime Elton John associates: lyricist Bernie Taupin, guitarist Davey Johnstone and bassist Dee Murray.

The 'Madhouse Rocks Tour' in support of From the Inside lasted from February to April 1979 and saw all songs from the album as regular parts of the setlist except "Millie and Billie", "For Veronica’s Sake" and "Jackknife Johnny".

In the top left corner is a door with a sign above that reads "the quiet room"; this is a hidden flap that opens to reveal Cooper, sitting in a padded cell with a straitjacket by his feet.

On the rear of the album is a picture of the back of an asylum building with the track listing on the double doors, which open to show all the inmates stampeding down the corridor, waving papers in the air stating their release.

Tom Carson of Rolling Stone, while stating that "the songs are full of good ideas", held that the songwriters and performers approached the concept too seriously, and that the album should have been done in a parody vein.

He also criticized that the session band are too talented and precise, arguing that audiences had become enamored of Alice Cooper as a musician who does not strive for competence, and they would not accept such a fundamental change to his sound.