The film centers on an unnamed Japanese salaryman who wakes up to find pieces of metal sprouting from various parts of his body and becomes haunted by visions of metal-oriented sexual fantasies.

Through his theatre work, he met like-minded people to perform in plays and later short films such as Kei Fujiwara and Taguchi.

After winning the Grand Prize at the Fantafestival in Italy, the film grew in popularity in Japan, becoming a top seller on home video for non-mainstream cinema.

The victim's tone changes from anger to love and says he needs to merge with the salaryman as he is overcome with rust that is attacking his body.

[12][13] Tsukamoto had performed and directed plays in high school, finding that they were "quite conventional" and that he preferred to do more experimental theatre.

Working with enthusiastic supporters led to Tsukamoto being able to make films and plays without outside funding and outside influences from production companies.

He recalled that in those eighteen months he was almost never at home, and that working as a corporate employee for long hours was a major influence on Tetsuo: The Iron Man.

[17] His plays retained the experimental style of his previous stage work, and connected him with Kei Fujiwara, who had been a member of Jūrō Kara's company.

[19] Tsukamoto's first work was The Phantom of Regular Size, a short film made with members of his Kaiju Shiata group, about a salaryman whose body eventually turns into scrap metal.

[20] Mes noted the short had themes and elements that would be expanded upon in Tetsuo: The Iron Man such as a woman with a metallic claw hand and the adverse effects of city life on people.

[22] The choice was made after seeing some Derek Jarman films which were shot in black and white and when blown up to 16mm and 35mm projections, Tsukamoto felt the excessive grain produced interesting imagery.

[23] The costumes in the film were made from scrap metal and small parts of electronic appliances stuck onto the actor with double-sided adhesive tape.

Initial tests led to Taguchi being in great discomfort, saying that at the end of a shooting day, his skin felt like sandpaper.

[27] After four months of shooting, Tsukamoto began developing what footage he had in the editing room, which he had access to for free from former co-workers at Ide.

Tsukamoto found himself emotionally and physically exhausted during the editing process, especially on hearing loud banging noises from the sound effects in the film again and again.

Through an acquaintance, Tsukamoto found a tape by a group titled Zeitlich Vergelter led by the musician Chu Ishikawa.

"[34] Tsukamoto expanded on this in an interview with The Japan Times in 1992, stating an interest in the erotic elements of juxtaposing a soft body against hard iron.

The term became known as a subgenre of science fiction in both literature and film that explored the relation of the human body in an ever-growing urban landscape dominated by technology.

In a 1993 interview in Cinefantastique, Tsukamoto stated he was impressed by David Cronenberg's film Videodrome (1983) and became aware of the burgeoning cyberpunk movement which led him to make Tetsuo: The Iron Man.

[35] Tsukamoto felt that Ridley Scott's Blade Runner (1982) and Cronenberg's Videodrome were "two parents of Tetsuo", while finding his work was different from cyberpunk, as he found the genre dealt with the period after the destruction of modern cities.

[37] Mes expanded on the themes of the film, stating that Tsukamoto works from a Japanese context which involves the negative aspects of life in a metropolis like Tokyo.

Tsukamoto saw city life, working office jobs, and spending hours commuting as "numbing the senses and robbing people of their humanity.

[25] According to Chikako Shimoaka of The Japan Times, Tetsuo: The Iron Man performed extremely well with over 10,000 copies on home video by 1992.

[29] Mark Thompson commented on the films new reception in Japan, by saying like Akira Kurosawa or the band Shonen Knife "an artist without an appreciative domestic audience, somehow finds fans and praise abroad, and returns home a folk hero.

[42] Arrow Video released the Solid Metal Nightmares set, a collection of Shinya Tsukamoto's films on Blu-ray, including Tetsuo: The Iron Man,[43] on May 26, 2020.

[44] From contemporary reviews, critics commented on the film's originality and what Tony Rayns in Sight & Sound referred to as a "gleefully extremist" style.

"[3] In the book The Definitive Guide to Horror Movies, James Marriott found that the film became wearying on repeated watches, and only Tsukamoto's Tokyo Fist came close to reaching Tetsuo: The Iron Man's visceral impact.

"[52] Tsukamoto stated that the sequel, Tetsuo II: Body Hammer (1992) was made with more of a narrative to reach a wider audience.

[29][53] Attempt to make a third Tetsuo film with American collaborators, including director Quentin Tarantino, was discussed in the early 1990s but was never made.