[3] Spreading the Disease was recorded at the Pyramid Sound Studios in Ithaca, New York with Canedy, while Jon Zazula served as executive producer.

The album featured the single "Madhouse", for which a music video was produced, but it did not receive much airplay on MTV, because the station believed the content was degrading to people with mental illnesses.

The cover art was made by Peter Corriston and Dave Heffernon, who had worked on Led Zeppelin's Physical Graffiti sleeve.

[8] Canadian journalist Martin Popoff calls the album "a shocking blast of noise from a long-haired bunch of punks that knew their own business", praising the "deceptively chaotic songcraft" and Belladonna's vocals.

Stagno said Spreading the Disease had "excellent" sound and production and recommended the album for fans of thrash metal.

[15] Frank Trojan of Rock Hard wrote that Spreading the Disease had more potential and intelligence than Fistful of Metal, as well as more differentiated songs.

[14] British author Joel McIver described Spreading the Disease as "the sound of pure determination, at a point in metal history where boundaries were being pushed every day.