The song's lyrics were written by lead vocalist Scott Weiland and bassist Robert DeLeo. DeLeo also wrote the song's music. DeLeo stated the following about "Creep:"
Musically speaking I was thinking about a song along the lines of 'Heart of Gold' by Neil Young, which is in the key of D-minor, the saddest key of all. Scott was thinking about the lyrics, and at that time in our lives we were struggling very much. What Scott was writing about was a real-life situation. Also about me, the thing about the gun. 'Creep' is a very demeaning word. It was one of those instances where we looked at ourselves, looked in the mirror.