The track was the first of three singles from the band's last studio album Strangeways, Here We Come. As such, it was the last single to include newly recorded material on the B-side. It holds the distinction of containing the last recorded Smiths song, "I Keep Mine Hidden". Also included—and recorded at the same session—is a cover version of a Cilla Black song, "Work Is a Four-Letter Word".
Morrissey's insistence on releasing this song as a single incurred the wrath of Johnny Marr who left the band not long afterwards. The video, which featured clips from the film The Leather Boys (starring Rita Tushingham), was directed by Tim Broad. BBC Radio 1 refused to play the song. Morrissey later commented, "You're not really supposed to like those songs. They're very depressing and not supposed to be played on radio."
The cover features playwright Shelagh Delaney from a 1961 edition of A Taste of Honey. The photo was tinted grey for 7"s in all countries except in Australia where it was tinted green as for the 12"s. This was the second time Delaney appeared on a Smiths cover; she appeared as the cover star on the then-recently released Louder Than Bombs album.
The song is a first person narration by a man whose girlfriend is in a coma. The narrator describes his conflicting feelings ("There were times when I could have murdered her / But you know I would hate anything to happen to her"). He says he doesn't want to see her, then says he does. The repeated assertion "I know it's serious" is undercut by his careless tone and "the light playful accompaniment by the other members of the band".
Mojo Nixon's cover of "Girlfriend in a Coma" on his 1995 album Whereabouts Unknown is in his usual psychobilly style. After the bridge, Mojo asks that the listener not blame him for the lyrics, launching into one of his trademark "rants" in which he finally declares that "I, Mojo Nixon, am the anti-Morrissey!"
Archive covered this song on their unplugged record in Paris in 2003, the album was released in 2004.