Liz Truss became prime minister on 6 September 2022, following the resignation of Boris Johnson and her victory over Rishi Sunak in the Conservative leadership election.

[3] The Bookseller quoted Cole and Heale as saying Truss "has been written off, belittled and undermined throughout her march to power", and expressing a desire to explain her rise to the prime minister's office.

Robbie Griffiths of the Evening Standard speculated on 5 October that, with Out of the Blue set to be sent to the printers "in the next few days", Truss's "turbulent start to the job" put Cole and Heale in a difficult position.

[7] On 19 October, the subtitle was changed, replacing the word "astonishing" with "explosive";[8] the book was for a time pulled from Amazon in the United States for review.

[12] Private Eye accused Starmer of stealing the joke from the issue they had published that day, which referred to Out of the Blue as "Due out on 8 December.

In a press release, HarperCollins quoted Cole and Heale as saying, "The irony is not lost on us that our biography of a politician whose rise and fall was built upon her ability to shapeshift with startling speed, has itself now needed a lightning retool to keep up with her.

[18] The book is split into two parts, with the first detailing Truss's early life and path to the premiership and the second recounting her seven weeks as prime minister.

[18] Out of the Blue then recounts Truss's campaign for a seat in the House of Commons, covering the difficulties that arose due to her previously undisclosed affair with Mark Field, a former Conservative MP.

The book also portrays her as having a penchant for media exposure over policy meetings, preferring photo ops to trade discussions with diplomats and having civil servants go to lengths to make sure she had good opportunities to post to Instagram.

Ivers wrote for The Times that the book "makes for a fantastic read" but "bears more resemblance to the work of Armando Iannucci" than Robert Caro.