After the success of Stay Hungry, Twisted Sister were faced with the question whether they should continue in a more pop-oriented direction or return to their early heavy metal roots. They tried to do a bit of both, but the approach proved unsuccessful since Come Out and Play marked the start of the band's decline. According to an interview with lead singer and songwriter Dee Snider, found in the CD sleeve of Club Daze 1: The Studio Sessions, The Shangri-Las cover "Leader of the Pack", which was first included on the early EP Ruff Cuts (1982), was intended to boost the band's popularity while keeping old fans pleased. Eventually neither that nor "Be Chrool To Your Scuel", featuring such musical guests as Alice Cooper, Brian Setzer, Clarence Clemons and Billy Joel among many others, received the reaction that the band and their record label were expecting.
Although the album sold more than 500,000 copies, earning it Gold status, the supporting tour was a fiasco, with cancelled dates and low attendances. Drummer A.J. Pero left the band after the tour ended in 1986, contributing to the chaos which eventually led to band's breakup after the release of Love Is For Suckers in late 1987.
From a musical viewpoint, the album was not a huge departure from Stay Hungry, despite a little more commercial sounding production by Scorpions producer, Dieter Dierks.
The music videos for "Leader of the Pack" and "Be Chrool to Your School" followed the comedic nature of band's earlier videos, but the latter, featuring Alice Cooper, was banned by MTV on the grounds that it was too offensive. There was no video made for the album's final single, "You Want What We Got".
In 1986 the band released the Come Out and Play: The Videos home video on VHS, which included four videos ("We're Not Gonna Take It", "I Wanna Rock", "Leader of the Pack" and "Be Chrool to Your Scuel") tied together by scenes of Dee Snider in a metal scrapyard being visited by kids and others questionables in need of advice to their problems, to the tune of "Come Out and Play". This home video has not since been issued on DVD.
The title track featured Dee Snider clicking bottles together saying "Twisted Sister, come out and play" several times in the beginning, a reference to the 1979 cult classic movie The Warriors, when the main villain, Luther, chants "Warriors, come out to play" while clicking bottles together as well.