O'Brian's biographer has placed the novel at the start of what he called the author's magnum opus, a series that has become perhaps the best-loved roman fleuve of the 20th century.

Events in the novel also largely take place in the Mediterranean, with the French, British, and Spanish navies attempting to capture and disrupt the merchant shipping of their enemies.

Jack Aubrey, a shipless lieutenant wasting away in the Royal Navy port of Mahon in Minorca, meets Stephen Maturin, a destitute Irish-Catalan physician and natural philosopher, at a concert at the Governor's Mansion.

Dillon and Maturin recognize each other, having previously met (a fact they keep to themselves) as members of the United Irishmen, a society dedicated to Irish home rule and Catholic emancipation.

Dillon suffers a crisis of conscience when ordered to intercept an American ship thought to be harbouring Irish rebels, and he works to help them avoid capture.

Maturin, who has never been aboard a man-of-war, struggles to understand nautical customs, and the crew explain to him (and to the reader) naval terminology and the official practice whereby prize money can be awarded for captured enemy vessels.

His convoy duties complete, Aubrey is permitted by Admiral Lord Keith to cruise the Mediterranean independently, looking to capture French and Spanish merchant vessels, at which he is very successful, taking many prizes.

Sophie meets and defeats the much larger and better-armed Cacafuego, a Spanish 32-gun xebec-frigate, though a number of the crew, including Dillon, die in the bloody action.

Yet, on the other hand, I have not felt slavishly bound to precise chronological sequence; ... within a context of general historical accuracy I have changed names, places and minor events".

[7] Although Aubrey's exploits are historically-sourced, his personality is O'Brian's own invention and differs significantly from that of the real Cochrane,[11] a Scot who could at times be rash, confrontational and disagreeable.

[14][8] One of the most spectacular single-ship victories in British Naval history,[15] the El Gamo incident captured the public imagination and founded the reputation of the Speedy's commander, Thomas Cochrane.

[20] In the 1960s two of O'Brian's seafaring books for children, The Golden Ocean (1956) and The Unknown Shore (1959), caught the attention of a US publisher, J B Lippincott, who were seeking an author to follow in the footsteps of C S Forester, creator of the Hornblower series of novels.

[21][24] In 1989 Starling Lawrence, an editor with the US publisher W W Norton, borrowed a copy of The Reverse of the Medal from O'Brian's London literary agent to read on his flight home to New York.

[21] C S Forester having died just a few years earlier, some critics were left bewildered and disappointed by the complexity of O'Brian's creation after the predictability of the Hornblower series.

[32] The sailor Sir Francis Chichester, recently returned from his 1967 single-handed voyage round the world, described the book as "the best sea story I have ever read",[33] a quote which the publishers adopted for use on the novel's front cover.

Also used on the book's jacket in Britain was a heartfelt quote from the author Mary Renault, "A spirited sea-tale with cracking pace and a brilliant sense of period.

[36] By 2000, O'Brian's reputation was such that his American biographer Dean King was able to place Master and Commander at the start of what he called the author's magnum opus, a twenty-novel series that has become perhaps the best-loved roman fleuve of the twentieth century: "[an] epic of two heroic yet believably realistic men that would in some ways define a generation".

[38] Writing in 2013, the author Nicola Griffith professed herself smitten: "In these books every reader who loves fiction both intellectually and viscerally will find something to treasure – and every writer something to envy.

[39] The 2003 Peter Weir film Master and Commander: The Far Side of the World, starring Russell Crowe and Paul Bettany, uses some of the characters, dialogue and events from the Aubrey–Maturin series, but does not faithfully reproduce the plot of the books.