Bend Sinister was the third and last Fall album to be produced by John Leckie. When recording began, the band were without a drummer, as Karl Burns was fired shortly before sessions began. Ex-member Paul Hanley stepped in at first before permanent replacement Simon Wolstencroft was found. However, Leckie and Mark E. Smith argued during the recording, with Smith complaining that "he'd always swamp everything, y'know, put the psychedelic sounds over it". Leckie, for his part, drew the line at Smith's insistence that some tracks be mastered from a standard audio cassette which Smith had been carrying around and listening to on a Walkman. Neither Smith nor Leckie speak highly of the album today. Nonetheless, the record contained their version of "Mr. Pharmacist", originally by US garage rock band The Other Half, which gave The Fall their first UK Top 75 entry, and remains a regular feature of the group's live set to this day.
Critics noted a darker than usual sound for the band. Trouser Press called it "a rather gloomy, dark-sounding record".Allmusic described it as a "distinctly down affair".