The last single to be released during Williams' lifetime, it reached #1 on the BillboardCountry Singles chart posthumously in January 1953. Co-writer Fred Rose, who died a year after the song's release, played a critical role in the development of Williams' songwriting; as Colin Escott points out, it was up to Rose "to separate the gold from the dross and work with Hank to transform the best ideas into integrated, complete statements, taut with commercial logic. If Rose contributed substantially, as he did on "A Mansion on the Hill" and later "Kaw-Liga," he took half-credit; if he simply doctored Hank's songs, he didn't take a share. Rose knew that he would get the publisher's half of the royalty, and there is consensus that he was not a greedy man."
Meant to be a humorous song, as evidenced by its ironic title and chorus, the composition took on additional poignancy following Williams' death. In fact, the urban legend that the song was #1 at the time of his demise is not far from the truth, as he did in fact die in the early hours of January 1953. Williams recorded the song at Castle Studio in Nashville on July 13, 1952 with backing provided by Jerry Rivers (fiddle), Don Helms (steel guitar), Chet Atkins (lead guitar), Chuck Wright (bass) and probably Ernie Newton (bass). Atkins recalled later, "We recorded 'I'll Never Get Out of this World Alive' and after each take, he'd sit down in a chair. I remember thinking, 'Hoss, you're not jivin',' because he was so weak that all he could do was just sing a few lines, and then just fall in the chair."