Cohen had received positive attention from critics as a poet and novelist but had maintained a keen interest in music, having played guitar in a country and western band called the Buckskin Boys as a teenager.

Writing for Mojo in 2012, Sylvie Simmons recalls, "When Leonard heard the result, he was not happy; the orchestration on 'Suzanne' was overblown, while everything about 'Hey, That's No Way to Say Goodbye' felt too soft.

The singer and producer also quarreled over a slight stop in the middle of "So Long, Marianne" – a device Cohen felt interrupted the song.

According to biographer Ira Nadel, although Cohen was able to make changes to the mix, some of Simon's additions "couldn't be removed from the four-track master tape".

[4] The instrumentalists – not credited on the album sleeve – included Chester Crill, Chris Darrow, Solomon Feldthouse and David Lindley of Kaleidoscope, who had been recruited personally by Cohen after he saw the band play at a New York club.

Mojo has described the album as "not only the cornerstone of Cohen's remarkable career, but also a genuine songwriting landmark in terms of language, thematic developments and even arrangements.

'"[8] When Cohen played in the Isle of Wight in 1970, he told the crowd that he'd written "One of Us Cannot Be Wrong" in a peeling room in the Chelsea Hotel when he was "coming off amphetamine and pursuing a blond lady that I met in a Nazi poster.

On the back cover of the album is a Mexican religious picture of the Anima Sola depicted as a woman breaking free of her chains surrounded by flames and gazing towards heaven.

[19] The album received mixed reviews at the time of its release, with Arthur Schmidt of Rolling Stone writing, "There are three brilliant songs, one good one, three qualified bummers, and three flaming shits."

While praising "Suzanne" for its "moments of fairly digestible surrealism", The New York Times opined in a January 1968 review that on the alienation scale, Cohen rated "somewhere between Schopenhauer and Bob Dylan, two other prominent poets of pessimism".

[23] "Suzanne", "So Long, Marianne", "Sisters of Mercy", "Winter Lady", and "Teachers" were included on the soundtrack of the 1971 film Beware of a Holy Whore by Rainer Werner Fassbinder.

A remastered version, with the bonus tracks "Store Room" and "Blessed is the Memory," was released in the United States on April 24, 2007, and in Japan on June 20, 2007.