Allmusic critic Stewart Mason retrospectively noted that the song is "less saccharine than many similar Elton John and Bernie Taupin ballads" and praised the "somewhat uncharacteristic emotional directness" of its lyrics.
[4] Rolling Stone magazine's Jon Landau praised the song when it was released, writing: "Mona Lisas and Mad Hatters" shows how much John can really do in the space of a single cut.
The concert was meant primarily as a tribute for family members and fellow workers of New York's Fire and Police and Emergency Medical Services departments, who had been participating in the ongoing recovery efforts at the demolished World Trade Center complex following the terrorist attacks of 11 September 2001.
The song was used in the film Almost Famous, in a scene in New York City, highlighting the loneliness of Kate Hudson's character, who overdoses on Quaaludes and champagne.
[4] A more upbeat sequel to the song called "Mona Lisas and Mad Hatters (Part Two)" was recorded 16 years later for John's album Reg Strikes Back.