Produced by Fred Rose, Williams recorded the song at his last session at Castle Studio in Nashville, Tennessee, on September 23.

Propelled by Hank Williams' recent death during a trip to a New Year's concert in Canton, Ohio, the song became an instant success.

By 1952, Williams was enjoying a successful streak, releasing multiple hits, including "Honky Tonk Blues", "Half as Much", "Settin' the Woods on Fire", "Jambalaya (On the Bayou)" and "You Win Again".

Already a periodic alcoholic, he developed serious problems with morphine and painkillers prescribed to ease his severe back pain caused by an unsuccessful operation to relieve spina bifida.

[5] Soon after, Williams met Billie Jean Jones backstage at the Ryman Auditorium, a native of Shreveport, Louisiana, who was, at the time, dating Faron Young.

[6] While driving from Nashville, Tennessee to Shreveport to announce the wedding to her parents,[7] Williams talked to her about his previous marriage and described Audrey Sheppard as a "cheatin' heart", [8] adding that one day she would "have to pay".

While traveling to a scheduled New Year's show in Canton, Ohio, the driver found Williams dead on the back seat of the car during a stop in Oak Hill, West Virginia.

[19] Released in the wake of his death, the song became synonymous with the myth of Hank Williams as a haunted, lonely figure who expressed pain with an authenticity that became the standard for country music.