In this book, Hawking and Ellis attempt to establish the axiomatic foundation for the geometry of four-dimensional spacetime as described by Albert Einstein's general theory of relativity and to derive its physical consequences for singularities, horizons, and causality.

[3] According to the mathematical physicist John Baez from the University of California, Riverside, The Large Scale Structure of Space–Time was "the first book to provide a detailed description of the revolutionary topological methods introduced by Penrose and Hawking in the early seventies.

The book, now considered a classic, has also appeared in paperback format and has been reprinted many times.a A fiftieth anniversary edition was published by Cambridge University Press in February 2023.

He believed Hawking and Ellis did a great job summarizing recent developments in the field (as of 1974) and that the intended audience is a doctoral student (or higher) with a strong mathematical background and prior exposure to general relativity.

[7] Theoretical physicist John Archibald Wheeler of Princeton University recommended this book to anyone interested in the implications of general relativity for cosmology, the singularity theorems, and the physics of black holes, presented in an almost Euclidean fashion, though he acknowledged that this is not a textbook due to its lack of examples and exercises.