Originally recorded by country music artist Mark Wills in 2003 on his album And the Crowd Goes Wild, it was covered by Bellefire a year later.
[1] Rascal Flatts then recorded the song as well, and per producer Dann Huff's suggestion, it made their album Me and My Gang.
Rascal Flatts also performed the song live with Kelly Clarkson at the Academy of Country Music Awards in 2006.
She expresses anger for her father who she blames for making her boyfriend leave, resulting in his demise in a car accident.
The girl's very hurt mother watches her daughter's anger for her father and cries as she feels helpless over this unfortunate situation.
In 2007, German Eurodance trio Cascada recorded a cover of "What Hurts the Most" for their second studio album, Perfect Day (2007).
The releases featured remixes by several disc jockeys, including Darren Styles, Spencer & Hill and Flip & Fill.
[26] "What Hurts the Most" was solicited to mainstream radio stations on December 11, 2007, in the United States, following its digital and physical release within the two weeks before.
In contrast to the original version, Cascada's cover of "What Hurts the Most" deviates from the country sound and replaces it with Europop electronic beats and elements typical of DJ Manian and Yanou productions.
[27] Sharon Mawer of AllMusic noted that despite the heavy electronic beats, lead singer Natalie Horler's vocals are never dominated by the music.
[27] According to the digital music sheet published at Musicnotes.com by BPJ Administration, the song is composed in a key of F♯ minor while carrying a tempo of 144 beats per minute.
[30] Chuck Taylor of Billboard gave "What Hurts the Most" a positive review, writing that "this track is remixed into a frothy uptempo anthem, complete with requisite percussive thump and an exulted vocal (with 12 mixes in all) that leaves the lyric's potential heartbreak in the dust."
Taylor ended his review, asking "Wouldn't it be wondrous if American programmers renewed their vow in 2008 to put variety on the airwaves—or do we really need a fifth entry in the top 10 from T-Pain?
[37] Despite its low peak on the Hot 100, the song managed to sell more than 500,000 downloads, earning a Gold certification by the Recording Industry Association of America in October 2009.
The video opens with Horler sitting in a studio apartment living room holding a note saying "I can't sorry".
Near the end of the second chorus, Horler is sitting against a white brick, with mascara running from her eyes, telling that she was crying.
As the song approaches the last chorus, the house party ends with the guests exiting Horler's apartment.
As the video nears the final chorus, Horler is at a house party with her friends, appearing lonely and heartbroken.