It was broadcast live and available only through pay-per-view (PPV) and the livestreaming services Peacock and the WWE Network.

First held in 2009, the concept of the show came from WWE's established Hell in a Cell match, in which competitors fought inside a 20-foot-high roofed cell structure surrounding the ring and ringside area.

Hell in a Cell replaced No Mercy in the October slot of WWE's pay-per-view calendar.

During the COVID-19 pandemic (2020–2021), Hell in a Cell was the only PPV event to be held twice in WWE's bio-secure bubble called the ThunderDome; the 2021 event was also the final PPV to be held in the ThunderDome before WWE resumed live touring in July that year.

In early 2009, World Wrestling Entertainment (WWE) ran a poll on their website allowing fans to pick the name for that year's October pay-per-view (PPV), which would feature the promotion's established Hell in a Cell match.

[15] The 2020 event was notable for having the first "I quit" match contested inside of the Hell in a Cell structure.

Its slot was initially replaced by what was to be a revival of King of the Ring, rebranded as "King and Queen of the Ring", but that was changed to Night of Champions, in turn reviving Night of Champions.

[19][20][21] This came after reports that WWE Chief Content Officer Triple H wanted to discontinue some of the gimmick events like Hell in a Cell so that the match itself could return to being the culmination of big feuds instead of something that has to be done each year because of the event.