[1] The song was released digitally on May 18 and 21, 2010 on the US and worldwide, respectively, on iTunes as well as an animated lyric video on YouTube, which received over 275,000 plays in 24 hours.

[8] "Nightmare" was released on July 27, 2010, as a downloadable track in Rock Band 2 along with Seize the Day and Scream.

It was discovered by fans that the face of Jimmy "The Rev" Sullivan, the band's deceased drummer, can be seen on both the single and album cover.

1 most added track at Active Rock radio in the US during one week of May 2010 and sold over 23,000 units in its first day.

[14] The video depicts lead vocalist M. Shadows about to undergo surgery, when the surgeons take him out of the room on a gurney and wheel him through the hallway of the hospital.

Shadows then notices the torn-down former drum kit of the band's deceased drummer, The Rev, when he toured with them to support their record City of Evil.

The surgeons move him through halls and he sees the members of Avenged Sevenfold acting mentally insane, such as rhythm guitarist Zacky Vengeance convulsing on the floor in a straitjacket (and later waltzing with a skeleton), lead guitarist Synyster Gates continually banging his bloodied forehead against the window of a door, and bassist Johnny Christ crawling on the ceiling with a skeleton, as well as disturbing images of children playing and soaked in blood.

Towards the end of the video, M. Shadows begins to fight the gurney, wanting to get off, as they wheel him toward a room being led by two young boys.

The band used Jacob's Ladder as inspiration for the video because they knew it was one of The Rev's favorite movies.

However, on the week ending August 14, 2010, the song re-entered at number 83 due to the release of the album.