Vocalist Brendon Urie wrote the song to express personal struggles and convictions many years prior to its official production for Vices & Virtues.

"The Ballad of Mona Lisa", written by lead singer Brendon Urie, was one of the first tracks composed for the band's third album, Vices & Virtues.

The song was also inspired by Urie's move from Las Vegas, Nevada, where he's lived his entire life, to Santa Monica, California, with Panic!

[5] The song's title is an allusion to Mona Lisa, the famous Renaissance-era oil painting by Leonardo da Vinci.

We thought that would be an easy way to describe how we were masking our own emotions and trying to figure out how we can solve the bad choices we make.

[11] The video received 120,000 streams on MTV.com within the week of its debut there and, as of April 3, 2022, has over 189.85 million views on Fueled By Ramen's official YouTube Channel.

William Goodman of Spin, regarding the single, described the song as "an anthemic power-rock ballad with dark and personal undertones,"[18] while John MacDonald, in a review of the band's first official live show of the Vices & Virtues Tour, commented "At the Bowery, Panic!

swung the song's sinister faux-cabaret verses into an absolutely towering chorus -- one that's destined to get blasted out of every sports bar and strip mall in the country over the next few months.

"[23] The track was described by Alternative Press as "[having] the upbeat pop energy of A Fever You Can't Sweat Out, with the focus and clarity of Pretty.

"The Ballad of Mona Lisa" re-entered the Billboard Hot Digital Songs chart at #142 upon the release of Vices & Virtues.

"When we were talking about the concept, somebody had the idea to kind of tie in to the beginning of the "Sins" video, and we realized it would work with it", Smith said.

"[27] The video’s main feature was Urie encouraging a little girl to open the dead body’s hand and find a note.

The note says, “Mary did it,” saying that one woman from the crowd who had been trying to stop communication with Urie had murdered the man and she is captured by a net.

[27] They also brought in additional cast members to further populate the scene and create a richer atmosphere with a unified aesthetic.

In addition, The League's Creative Director Nick Baumann acted as the production’s primary steampunk consultant.