It was the third rock album release by the star and her final full-length recording. Originally recorded in 1968, the LP was released four years later, a few months before West turned 79. The record consisted of covers of rock classics and new songs. It was produced by Ian Whitcomb and featured background vocals by The Mike Curb Congregation. Great Balls of Fire was not a commercial success and did not chart.
The cover of Neil Sedaka's "Happy Birthday Sweet Sixteen" does not feature the original words and instead features new tongue-in-cheek lyrics written by Whitcomb, referring to age 21 as West celebrates the coming of age of a devoted fan. That version is generally known as "Happy Birthday Twenty-One". West later performed this song in her final motion picture, 1978's Sextette.