Created by writer Peter David and artist Dale Keown, the character first appeared in The Incredible Hulk vol.

[1] In the 1991 storyline in which the Guilt Hulk first appears, Doc Samson employs the Ringmaster's expertise with hypnosis in an attempt to unify Banner's fractured mental state.

During these hypnosis sessions, Banner interacts with his warring split personalities, the Savage Hulk and Joe Fixit.

[2] The Guilt Hulk, possessing a slightly altered appearance, returns years later as Banner is dying of ALS.

[2] In an issue of What If?, Banner's initial confrontation with the Guilt Hulk ends with him "killing" the entity himself which leads to him gradually transforming into Maestro.