The song was written following his first trip to England in December, 1962, upon what he thought to be the completion of his second album. It is debated as to whom this song is a tribute to; some claim former girlfriend, Echo Helstrom, and some Bonnie Beecher, both of whom Dylan knew before leaving for New York. However, it is suspected that this song could have been inspired by his then girlfriend, Suze Rotolo. Dylan left England for Italy to search for Suze, whose continuation of studies there had caused a serious rift in their relationship. Unbeknownst to Dylan, Rotolo had already returned to the United States, leaving about the same time that Dylan arrived in Italy. It was here that he finished the song, ostensibly inspired by the apparent end of his relationship with Rotolo. Upon his return to New York in mid-January, he convinced Rotolo to get back together, and to move back into his apartment on 4th Street. Suze Rotolo is the woman featured on the album cover, walking arm in arm with Dylan down Jones Street, not far from their apartment.
While in London, Dylan met several figures in the local folk scene, including English folksinger Martin Carthy. "I ran into some people in England who really knew those [traditional English] songs," Dylan recalled in 1984. "Martin Carthy, another guy named [Bob] Davenport. Martin Carthy's incredible. I learned a lot of stuff from Martin." Carthy exposed Dylan to a repertoire of traditional English ballads, including Carthy's own arrangement of "Scarborough Fair," which Dylan drew upon for aspects of the melody and lyrics of "Girl from the North Country," including the line from the refrain "Remember me to one who lives there, she once was a true love of mine". Musically, this song is nearly identical to his composition "Boots of Spanish Leather", composed and recorded one year later for the album The Times They Are a-Changin'.
Cash also recorded a duet with Dylan himself during their February, 1969 recording session while Dylan was in Nashville for Nashville Skyline. This version appears in the 2012 film Silver Linings Playbook starring Bradley Cooper and Jennifer Lawrence.
Waylon Jennings performed a live cover version in the early '60s on his album The Restless Kid — Live at JD's.
The Blue Things recorded a version of the song on their 1966 album Listen & See.
Pete Townshend's "North Country Girl," on his album All the Best Cowboys Have Chinese Eyes, is another variant on the traditional song that Dylan based "Girl from the North Country" on, albeit in a more pop-oriented manner. Since the 1990s, he has based his live performances of the song on Roy Harper's 1974 recording.
Howard Tate recorded a soul version of the song on Howard Tate (1972).
The Secret Machines recorded a version of the song, and it occasionally makes its way onto setlists during tours.
Tony Rice recorded a version on his album Tony Rice Plays and Sings Bluegrass
Sam Bush also recorded a version of this song which is on his live album, Peaks of the Telluride.