The story follows Lui, a young woman in Tokyo whose fascination with body modification and sadomasochistic sexual activity drives her to make increasingly dangerous personal choices.

Her father Mizuhito Kanehara, a professor of sociology at Hosei University, brought her along on a year-long research trip to San Francisco, where she occasionally attended an American school.

During her stay in the United States, with her father's permission, she began reading stories by Ryū Murakami and Amy Yamada that contained strong violent and sexual themes.

[2] Against the wishes of her mother Chieko, Kanehara dropped out of her first year of high school, left home, and began to write stories, including Snakes and Earrings, that drew on her own experiences with cutting, suicidal thoughts, body modification, and living with different boyfriends.

[2] Her father supported her writing by arranging for her to participate in a fiction workshop for sophomores at his university, and by editing the Snakes and Earrings manuscript before it was submitted for the Akutagawa Prize.

After learning of Ama's demise, Lui tries to speed up the process of splitting her tongue by inserting larger studs too quickly, causing intense pain, and she stops eating, instead only drinking alcohol.

Mark Driscoll, writing in Cultural Critique, argued that while the book's graphic descriptions of tattooing, self-harm, and violent sexual activities revealed subcultures unfamiliar to many readers, Kanehara's portrayal of her characters as "consumerist, closed-off, and unwilling or unable to communicate with people outside their tribe" reinforced popular stereotypes about Japanese youth, particularly the part-time workers called freeters.

[4]: 77 In Japan Forum, Rachel DiNitto argued that expecting the subcultural elements of the book to express resistance to mainstream Japanese culture actually reflected a Western literary bias.

[11] Kanehara appeared at the Akutagawa Prize announcement ceremony wearing "an off-the-shoulder, cut jersey shirt with exposed bra straps, a flared mini skirt, stiletto heels, mid-thigh nylons, multiple earrings and grey-tinted contact lenses".

[12] In an English-language review of both Akutagawa Prize winning novels, Janet Ashby of The Japan Times criticized the "element of sexism" in the media hype over the two novelists, but also observed that both stories were "somewhat of a letdown", with Snakes and Earrings having a "particularly unsatisfactory ending".

[12] The unusual sales numbers and media spectacle surrounding the book drew international attention, including a profile in The New York Times that called the novel "a powerful portrait of this post-bubble generation".

While praising Kanehara's detailed descriptions and character development, Prudence Peiffer's review in Library Journal found the book's "hasty conclusion" predictable.

[24] Writing for Artforum, Christine Thomas similarly praised Kanehara's "keen observation of everyday reality", but noted that the ending was strained by its efforts to find redemption for the main character.

[25] Karen Karbo of Entertainment Weekly compared Snakes and Earrings to the Bret Easton Ellis novel Less than Zero, calling the ending "both chilling and oddly moving" but questioning the book's originality.

[26] A film adaptation of Snakes and Earrings, directed by Yukio Ninagawa and starring Yuriko Yoshitaka, Kengo Kora, and Arata Iura, started principal photography in November 2007.

[38][39] Writing for Variety, Russell Edwards panned the film, leveling criticism at weak directing and the performances of the male leads, while calling Yoshitaka an "alluring actress" who nevertheless "lacks the chops to carry the role".