[4][12] The studio band on "Positively 4th Street" featured Bobby Gregg (drums), Russ Savakus[13] (bass), Frank Owens[14] (piano), Al Kooper (organ) and Mike Bloomfield (guitar), with the song initially being logged on the studio's official recording session documentation under the working title of "Black Dally Rue".

[15] Although the song was recorded during the Highway 61 Revisited sessions, and shares much stylistically with the tracks on that album, it was saved for a single-only release, eventually charting in the top ten on both sides of the Atlantic.

[11] Critic Dave Marsh praised the song as "an icy hipster bitch session" with "Dylan cutting loose his barbed-wire tongue at somebody luckless enough to have crossed the path of his desires.

[21] The song, like most of Dylan's, is composed of a simple harmonic, or chordal, and melodic structure; the verse has a I-ii-IV-I progression followed by I-V-IV-vi-V.

Dylan begins by telling the unspecified second-person target of the song that they have a lot of nerve to say that they are his friend and then goes on to list a multitude of examples of their backstabbing duplicity.

magazine, Paul Williams, noted that the song's lyrics are uncharacteristically straightforward and devoid of the rich, poetic imagery present in the majority of Dylan's contemporaneous material.

[4] The lyrics of "Positively 4th Street" are bitter and derisive, which caused many, at the time of the song's release, to draw a comparison with Dylan's similarly toned previous single "Like a Rolling Stone".

Indeed, journalist Andy Gill described it as "simply the second wind of a one-sided argument, so closely did it follow its predecessor's formula, both musically and attitudinally".

[23] Cash Box described it as a "throbbingly bittersweet funky affair in which Dylan attacks those people who wouldn’t accept him when he was an unknown.

[25] The song is generally assumed to ridicule Greenwich Village residents who criticized Dylan for his departure from traditional folk styles towards the electric guitar and rock music.

[4] Many of the Greenwich Village folk crowd, who had been good friends of Dylan's, took offense and assumed that the song carried personal references.

This allegation is supported by the derisive, attacking tone of many of the songs on Bringing It All Back Home and Highway 61 Revisited, as well as the harsh and powerful textures of Dylan's electric sound.

[29] Dylan said in his best selling book Chronicles: Volume One that he preferred Johnny Rivers' version of "Positively 4th Street" to his own recording of the song.

[35] Other musicians and bands that have covered the song, include Lucinda Williams, on the live compilation album In Their Own Words, Vol.

[41][42] Comedian Jimmy Fallon performed a parody version of the song in 2016 with the lyrics replaced by those of Drake’s "Hotline Bling".