Frith wrote and composed all the music, with the exception of "This Old Earth", which was written and sung by Jane Siberry, and a cover of "The Way You Look Tonight".

The music was recorded at l'Office National du Film, Montreal, Quebec, Canada in August and September 1988, and was released on LP and CD in 1989 by the Belgian independent label, Crammed Discs.

In a review at AllMusic, Ted Mills described The Top of His Head soundtrack as "[a] less aggressive work compared to [Frith's] other releases, though not exactly gentle by any means.

[2] Nicole V. Gagné wrote in her 1990 book, Sonic Transports: New Frontiers in Our Music that The Top of His Head has "some of the strongest pieces Frith has ever made".

[4] Gagné was pleased to see the return of humour on the album after its absence on The Technology of Tears, but added that "you can feel a dark undercurrent, the frustrated inarticulacy of Speechless".