The story of the impacts in Japan on the residents of the two targeted cities and of the response of the Japanese government to the attack is interwoven with details of the Americans who carried out the missions and their reactions to the damage they had wrought.

Pellegrino faced criticism from members of the 509th Composite Group, the unit created by the United States Army Air Forces tasked with operational deployment of the two nuclear weapons, for including extensive details provided by Joseph Fuoco, who falsely claimed to have been aboard the mission to Hiroshima as flight engineer as a last-minute substitute.

Richard Rhodes, author of The Making of the Atomic Bomb said that he would have sought stronger confirmation for aspects of Pellegrino's story that represented "a radical change in the historical record".

[7] Pellegrino also faced questions about the existence of Father Mattias, a priest who was said to have survived the bomb in Hiroshima, and of John MacQuitty, who the book said officiated at his funeral.

[8] However, director James Cameron defended Pellegrino, saying "All I know is that Charlie would not fabricate so there must be a reason for the misunderstanding" and believes that it was caused by "elaborate deception to create a false account.

Released August 6, 2015, To Hell and Back: The Last Train From Hiroshima features new witness accounts and removal of the veteran who had exaggerated his war record.