The psalm forms a regular part of Jewish, Catholic, Lutheran, Anglican and other Protestant liturgies.

[12] Charles Spurgeon, however, rejects purely historical interpretations, stating: "Maschil, an instructive ode, not an idle lay, or a romancing ballad, but a Psalm of holy teaching, didactic and doctrinal.

[7] The Midrash Tanhuma teaches on this verse, "If a woman remains modestly at home, she is worthy that both her husband and children are Kohanim Gedolim [who wear golden clothes].

"[14] Although this is the only Psalm in which women are given a sustained presence, it has received criticism for its fairy-tale depiction of the bride's expected subservience to a handsome and powerful king.

[21][22] Since the early Middle Ages, monasteries have traditionally performed this psalm during the celebration of Monday matins, according to the Rule of St. Benedict (530).

The portion of the Psalm which refers to the 'Queen, in gold of Ophir' is also one of the set readings for mass on the Feast of the Assumption of the Blessed Virgin Mary.

[27] Heinrich Schütz wrote a setting of a paraphrase of Psalm 45 in German, "Mein Herz dichtet ein Lied mit Fleiß", SWV 142, for the Becker Psalter, published first in 1628.