Additionally, the song's lyrics deal with the consequences of society's high standards of beauty, and in "Pretty Hurts" eating disorders are depicted as one of the subjected results.

The song was put on hold for eight months by Rihanna's management, who failed to pay the track's fee, and as a result Beyoncé "slid into home base and threw the money down" to secure "Pretty Hurts" for herself.

[21] Chris Bosman from Consequence of Sound described "Pretty Hurts" as a "cinematic reach of modern Top 40 pop with the patience and melancholy of post-808s & Heartbreaks hip-hop.

[28] The song then transcends into a depiction of Beyoncé as a beauty pageant contest awaiting judgment in the lyrics, "Mama said, 'You're a pretty girl, what's in your head, it doesn't matter.

[29][30] The second verse of "Pretty Hurts"—"Blonder hair, flat chest/ TV says bigger is better/ South Beach, sugar free/ Vogue says thinner is better"—serve as an analysis of female body image and society's obsession with physical perfection.

[30][31][32] According to Tris McCall of The Star-Ledger, the song implicates that "American women are flung from their cradles into competition with each other, and are coached to disguise their flaws and distrust any gesture toward solidarity.

"[29] Additionally, the track's lyrics deal with the consequences of society's high standards of beauty,[13] and in "Pretty Hurts" eating disorders are depicted as one of the subjected results.

[20] Marc Hogan of Spin opined that "Pretty Hurts" resembled a speech accompanied by music and felt that it served as a political statement addressed to the beauty industry.

[29] McCall went on to opine that "Pretty Hurts" served a response to the criticism Beyoncé received for her performance of "The Star-Spangled Banner" during American president Barack Obama's second inauguration in 2013.

[40] Writing for the Los Angeles Times, Mikael Wood felt that with "Pretty Hurts," Beyoncé created "razzle-dazzle pop out of small-scale sentiments that might've seemed on paper like fodder for hushed ballads".

[43] Gill's view was shared by Consequence of Sound's Chris Bosman who felt the song's "dramatic and painful exploration of female beauty" made it a highlight on Beyoncé.

[44] Jem Aswad of Spin called "Pretty Hurts" the pièce de résistance of Beyoncé and described it as "a shimmering, melancholy-yet-radio-friendly landscape that perfectly suits the song's heavy subject matter".

[47] Dennehy's view was echoed by Emily Mackay of NME who went on to deem the track "inauspicious" and felt its lyrical content was reminiscent of "a City banker lecturing you on the need for spiritual rather than material wealth".

[15] Philip Cosores of Paste commented, "'Pretty Hurts' opens the album with didactic rhetoric without the grace of subtlety, with its repeated conclusion that the 'soul needs surgery,' hardly a poetic payoff that listeners deserve".

[80] To further promote the release, Beyoncé launched a website campaign—"What Is Pretty"—which asked fans to post photos and videos on Instagram, explaining their definition of beauty.

"[75] A scene from the clip which depicts Beyoncé preparing plastic surgery, consuming diet pills and vomiting, was initially excluded from the video's final cut.

Another scene featuring Beyoncé drowning in water while the beauty contest's host questions her life aspirations, was originally intended to depict her falling onstage.

'"[77] The video's ending was originally intended to depict archival footage of American actresses Halle Berry and Vanessa A. Williams, to promote beauty for African-American women.

However, Beyoncé sent a note to Matsoukas suggesting that footage from her childhood should be interpolated at the end of the song in order to connect it to the second music video from the album, "Ghost".

As the second verse finishes, the host calls Beyoncé on the stage and praises her for her performance at the competition, asking the crowd to applaud to the "beautiful and poised" in the contest.

[24] Similarly, NME's Emily Mackay who gave a mixed review for the song, felt that its visual "[saved] the day", and deemed the scene where Beyoncé wrecks her trophy shelf as "powerful".

[15] Jon Blistein of Rolling Stone called the video "intense" and "touching," wrote that the "shots of her bashing her trophy shelf prove way more cathartic than any pageant victory".

[12] Vanity writer Michelle Collins felt that the singer managed to make exercising look difficult and uncomfortable, and praised the scene where Beyoncé responds to the pageant judge questioning her life aspirations.

[87] Spin's Philip Sherburne alluded that the video was emotional and wrote that it offered "a story line that opens up a wealth of readings about race, skin tone, beauty standards, and her [Beyoncé's] own mutable image.

[48] Similarly, Shannon Kelley for TakePart said that the song "offers an honest commentary on an important reality", but highlighted the irony of its music video and felt that it manifested that "[Beyoncé is] not immune to the disease".

"[95] Although Daisy Buchanan of The Daily Telegraph praised the message of the song and its video, she wrote in her review that the clip was "pure hypocrisy" because she opined that Beyoncé had promoted "heavily sexualised and unattainable standards" with her body throughout her career.

Cragg deemed the clip "gorgeously shot" and opined that its magazine shoot style "slightly subverted by barely veiled sadness and tight rictus grins".

[100] The outfits were designed by Nicola Formichetti who took inspiration from Beyoncé's music video for "'03 Bonnie & Clyde", outlaw motorcycle clubs, and included references to her daughter Blue Ivy.

[102] In a review of one of the tour's concerts, Houston Chronicle writer Joey Guerra opined the song was oddly placed in the set list, but wrote that it "somehow worked perfectly as a late-set crescendo".

[106] On June 3, Dutch disc jockey R3hab released an uptempo electro house remix of the song during a concert for Gucci's Chime for Change, in honor of the one-year anniversary of its launching.