According to Bob Allen's book George Jones: The Life and Times of a Honky Tonk Legend, Jones first heard the song when Jack Clement played it for him at Gulf Coast Studio in Beaumont, which Clement owned with Bill Hall. The song had been written by Dickey Lee Lipscomb and Steve Duffy, two professional songwriters under contract to Clement's publishing company, so Clement was eager for Jones to record it. According to Allen, Jones had little interest, responding, "I don't like it too much. It's got too many damn 'just becauses' in it. I don't think nobody really wants to hear that shit, do you?"[1] Undeterred, both Clement and Hall continued to pitch the song to Jones. Raymond Nalley, brother of Gulf Coast session musician Luther Nalley, later recalled:
"They had this ole, wornout, rinky-dink tape recorder layin' around the studio...Everytime they'd try to lay that song on George, he'd just look at that damn tape recorder and ask 'em, 'How much you sell me that thing for?' One day, Bill Hall finally told him, 'Hell, George, if you'll record the song, I'll give ya the damn tape recorder!'"[1]
In his essay for 1994 Sony retrospective The Essential George Jones: The Spirit of Country, Rich Kienzle also states that Jones was underwhelmed by the song after Clement had "decided not to play George the tape but to sing him the song, altering the melody as he sang it to give it a stronger country feel." Jones himself always insisted he had no doubts about the song. Recalling his first impression of the tune, he insisted in the 1989 documentary Same Ole Me, "Boy, I just flipped! I said, 'Golly, lemme have this thing.'" In the 1994 video retrospective Golden Hits, he added, "It knocked me out. I couldn't wait to get into the studio." The song was released in April 1962, his first single release on United Artists after leaving Mercury, and it remained on the Billboard survey for twenty-three weeks, six of them at #1. In his autobiography I Lived to Tell It All, the singer wrote, "For years after I recorded it, the song was my most requested, and it became what people in my business call a 'career record,' the song that firmly establishes your identity with the public."[2] The B-side, "Sometimes You Just Can't Win", reached No. 17 on the C&W chart.[3] "She Thinks I Still Care" was one of seven records George would chart in 1962, and in the fall of 1963 he would travel to New York City and perform the song on Jimmy Dean's ABC network show.
Anne Murray remade "He Thinks I Still Care" for her 1973 Danny's Song album and in 1974 this track was issued as the B-side to Murray's cover version of the Lennon–McCartney-penned "You Won't See Me". While "You Won't See Me" was a No. 8 hit on the Billboard Hot 100 and No. 1 on the BillboardEasy Listening Singles chart, "He Thinks I Still Care" was shopped to country radio. In July, just as "You Won't See Me" peaked in popularity at Top 40 stations, "He Thinks I Still Care" became Murray's first No. 1 hit on the BillboardHot Country Singles chart.[5]
Elvis Presley recorded the song for his final studio album, Moody Blue and it was released as the B-side to his No. 1 country hit "Moody Blue" in 1977.
In the late 1970s, The Kendalls covered the song as the gender-neutral "You Think I Still Care".
Kirsty MacColl recorded the song, in the manner of a 1950s ballad (interpolating the melody of "Blue Moon") as "He Thinks I Still Care" on her 1981 album Desperate Character.
James Taylor often covered the song in concert, including a recording of it on his 1993 Live album.
Glen Campbell's final album Adiós has a new version recorded which was released June 2017.
Fat White Family's Saul Adamczewski and Childhood's Ben Romans-Hopcraft covered the song on their 2018 album Karaoke for One: Vol 1 under the band name Insecure Men.