Written by Freddie Mercury but credited to Queen, with uncredited lyrical contributions by Peter Straker, it was released as the second single from the band's 1991 album Innuendo.

"I'm Going Slightly Mad" had been mentioned by John Deacon in a letter printed in the Queen Fan Club magazine of Spring 1990.

During an evening with his friend Peter Straker, Mercury explained his idea for the song, which he wanted to feature lyrics of tongue-in-cheek one-liners inspired by Noël Coward.

[6]During 1991, Mercury recorded a short, "Totally Bonkers" version of the song as a message for Queen's 1991 fan club convention.

[8][9] It features the band dressed and acting in an absurd and surreal manner, including guitarist Brian May dressed as a penguin (a reprise of his outfit featured in the booklet of the first Queen album[10]), drummer Roger Taylor wearing a tea kettle on his head and riding a tricycle while Mercury sneaks up on him and is chasing him, a man in a gorilla suit, bassist John Deacon as a jester, and Mercury wearing a bunch of bananas as a wig, which corresponds with the line "I think I'm a banana tree".

Mercury wore thick makeup to cover up the blotches on his face, and an extra layer of clothing underneath to conceal his weight loss.