It was written by Andrea Martin, Robert Littlejohn Jr., Leon Carr, Earl Shulman, and Gerell Brewer, and produced by Jay Fenix & Andrea Martin.

The track spent nine weeks as number-one on the US Billboard R&B singles chart.

Fiona received a Grammy nomination in the category of Best Female R&B Vocal Performance for the track, however, the Grammy was awarded to Beyoncé for "Single Ladies (Put a Ring on It)".

The song samples "(Hey There) Lonely Girl" by The Softones.

The music video, "It Kills Me", was directed by Armen Djerrahian in 2009 and features Adam Rodriguez as Melanie's love interest.