Themed on medical crimes, the film stars Arun Vijay and Mahima Nambiar, with Vamsi Krishna, Aravind Akash, Amit Bhargav, Abhinaya, and Thambi Ramaiah, amongst others, in supporting roles.

Produced by Inder Kumar along with Arun Vijay, the soundtrack album and background score for the film were composed by Vishal Chandrasekhar.

[3][4] A woman named Jessica arrives at the St. Thomas Church in Villivakkam, outskirts of Chennai, where she confesses her sins to a priest.

In Chennai, ACP Vetrimaaran IPS is celebrating his elder brother Aravind and sister-in-law Abhinaya's wedding anniversary.

Everyone in the family is happy except for Vetri's mother, who berates Abhinaya for not bearing her a grandchild despite many years of marriage life.

Eventually, Thendral reveals that she saw two vehicles that day outside the church: one belonging to Jessica and another black SUV driven by a group of mysterious young men.

True enough, Kousalya receives a call instructing her to pay a huge sum of money in exchange for not revealing information that might destroy her career.

The person reveals himself as Gaurav and is part of a gang that has been blackmailing several women in the city who have legally undergone artificial insemination at Tulsi's hospital.

She had hired Gaurav's gang to get hold of her favorite cricket player's sperm in order to conceive his child.

Meanwhile, John is shown to be working as a lab assistant at Tulsi's sperm bank and was the one who had been manipulating the donor's records and passing on the information to Gaurav.

The next day, Vetri and Thendral discuss about the misuse of medical advancements in people and the importance of adopting orphans in the media.

In January 2016, Arun Vijay and director Arivazhagan announced that they would collaborate to work on a "high-octane action thriller" with a medical backdrop, which would begin in the following months.

[5][6] The script was developed in early 2016, with the story being inspired by a novel by writer Rajesh Kumar, which in turn was based on real events.

[7][8] A formal launch event was held in March 2016, with Arun Vijay announced that the venture will be produced by his friend, Inder Kumar, under Redhan The Cinema People banner.

[9][10][11] During April 2016, the team shot scenes in the dumpyard of Pallikaranai with Arun Vijay reportedly working for 36 hours in a single stretch.

[23] Prior to the official release, a premiere was held for media personalities, and the film drew positive reviews.

[27] The Deccan Chronicle noted it was "a welcomed relief from the recent drab of Kollywood", while The New Indian Express stated it had a "coherent screenplay which could have been better".

[28] Sify.com's reviewer wrote the film was "a good example of an entertaining cop thriller" adding "this sharply written slick investigative thriller, comes as a huge relief at a time where Tamil audiences are bombarded with several middling movies of big stars" and that "the film is also a perfect case study on how good writing and a technically sound team can offer quality entertainment, which is a rarity in Kollywood".

[29] Likewise, Sreedhar Pillai of FirstPost wrote "Kuttram 23 has a compelling story and is packaged in an entertaining format by Arivazhagan" and that "it is one of the better movies in recent times".