In largely self-produced sessions recorded at a band member's home, Williams and the Damn Band recorded traditional country music, western swing and bluegrass songs which focus on drug use, hedonism and the outlaw life, as well as criticism of the mainstream country music industry.

[4] The album's lyrical themes include drug use, hedonism and the outlaw life, as well as criticism of the mainstream country music industry.

On his website, Williams encourages fans to support independent record outlets that are more willing to stock the uncensored version of the album.

[6] Mark Deming of Allmusic gave the album 4 out of 5, writing, "There's a pure and soulful musical vision at the heart of Straight to Hell no matter how much Hank III lashes out against the confines of current country music and messes with the form, and that's what makes him most valuable as an outlaw -- there's lots of long-haired dope-smoking rednecks out there, but not many that can tap into the sweet and dirty heart of American music the way Hank III does, and Straight to Hell proves he's got a whole lot to say on that particular subject.

Club's Noel Murray gave the album a B+ rating, writing, "Just because Hank Williams III is the scion of country-music legends doesn't automatically excuse him from accusations of rednexploitation", claiming that the lyrics of "Crazed Country Rebel" "[pander] to people who think that 'authentic' country music has to be about outlaw losers, as though nobody in the heartland ever held onto a job or fell in love.