[7] Based on Shūgorō Yamamoto's 1959 short story collection, Akahige Shinryōtan,[1] the film takes place in Koishikawa, a district of Edo, towards the end of the Tokugawa period (i.e. early or mid-19th century), and is about the relationship between a town doctor and his new trainee.

Fyodor Dostoevsky's novel Humiliated and Insulted provided the source for a subplot about a young girl, Otoyo (Terumi Niki), who is rescued from a brothel.

However, for Yasumoto's post-graduate medical training, he is assigned to a rural clinic under the guidance of Dr. Kyojō Niide, known as Akahige ("Red Beard").

One of them is Rokusuke, a dying man whom Dr. Niide discerns is troubled by a secret misery that is only revealed when his desperately unhappy daughter shows up.

He agrees to marry Masae, but at the wedding announces that he will not accept the new position, but will stay at the clinic, turning down a comfortable and prestigious place in society to continue serving the poor alongside Dr. Niide.

[11] After finishing High and Low (1963), director Akira Kurosawa accidentally picked up Shūgorō Yamamoto's 1959 novel Akahige Shinryōtan.

[12] Although he initially believed it would make a good script for fellow director Hiromichi Horikawa, Kurosawa became so interested in it as he wrote, that he knew he would have to direct it himself.

[12] Kurosawa completed writing the script for the film in early July 1963, which he co-wrote with screenwriters Masato Ide, Hideo Oguni, and Ryūzō Kikushima.

The wood used for the main gate was over a hundred years old, and after filming, it was re-erected at the entrance to the theater that hosted Red Beard's premiere.

[12] Richie wrote that one could argue that Kurosawa "completely wasted his million yen set," as the main street is seen for only one minute (although its destruction was incorporated into the earthquake scene).

[28][29] However, the film received a mixed response from Western audiences; while it was a box-office success in Japan, it performed poor commercially abroad.

[30] Roger Ebert gave the film four stars in a review dated December 26, 1969, writing "Akira Kurosawa's Red Beard is assembled with the complexity and depth of a good 19th century novel, and it's a pleasure, in a time of stylishly fragmented films, to watch a director taking the time to fully develop his characters.

"[31] Michael Sragow of The New Yorker wrote "This 1965 film, the last of Akira Kurosawa's collaboration with Toshiro Mifune, is often derided as a soap opera.

But the story of a grizzled nineteenth-century doctor nicknamed Red Beard (Mifune) and his green physician (Yuzo Kayama) who learns human medical values from him — is actually a masterpiece.