The play is notable for its incidental music: a group of six compositions created by the author's brother-in-law, Jean Sibelius. The most famous selection is the opening number, Valse triste (Sad Waltz), which was later adapted into a separate concert piece.
The play is in three acts. Act I features the boy Paavali and his mother, who is ill. When she is asleep, music is heard, and she has a dream of dancers, who start to fill the room. She then joins them in their dance, but becomes exhausted. As the dancers leave, she begins to dance again. However, Death knocks at the door three times, and the music stops. Death claims her, in the form of her late husband.
Act II features Paavali years later as a wandering young man. At one point, he comes across a cottage, where an 'old witch' lives. In the cottage, Paavali bakes bread and lights the fire for the witch. She gives him a ring that allows him to see his future bride. The scene changes at once to a forest in summer, where Elsa, a young woman, sings to herself, and Paavali meets her. After sleeping beside each other, Paavali wakes to resume his travels, but Elsa wants him to remain. A flock of cranes flies overhead at that point, one of which separates from the group, carrying an infant to them.
In Act III, Paavali and Elsa have since been married. He has used his funds to build a school. Later, Paavali's and Elsa's house catches fire. As the house burns, Paavali reflects on his past life, and sees the ghost of his mother, holding a scythe, in the flames. In parallel with the end of Act I, Paavali's mother has come for her son. Paavali dies as the house collapses. The last scene sees the villagers consoling Elsa and the children and recalling Paavali. Elsa says at the end that Paavali lives in the hearts of the people.
Initially, Sibelius wrote six numbers for the 2 December 1903 production:
- Tempo di valse lente - Poco risoluto (Act I)
- Moderato (Paavali's Song: 'Pakkanen puhurin poika', for solo baritone, Act II)
- Moderato assai - Moderato (Elsa's Song: 'Eilaa, eilaa', for solo soprano) - Poco adagio (Act II)
- Andante (The Cranes, Act II)
- Moderato (Act III)
- Andante ma non tanto (Act III)
In 1904, he revised No. 1 as Valse triste, and it was performed in Helsinki on 25 April 1904. It was published as Op. 44 in 1905 by Breitkopf & Härtel, and immediately took on a life of its own. It became an instant hit with the public, and one of Sibelius's signature pieces. However, because of the publishing contract, Sibelius saw relatively little money in terms of royalties from the performances of Valse triste.
In 1906, he combined Nos. 3 and 4 and revised the music under the title Scene with Cranes. This was performed in Vaasa on 14 December 1906. Sibelius did not ascribe an opus number to it, it was not performed again in his lifetime, and it was not published until 1973, 16 years after his death.
In 1906, he wrote a Rondino der Liebenden for string orchestra, adapted from the music for Kuolema. It lay unperformed until 1911.
In 1911, Järnefelt produced a revised version of the play. For this, Sibelius wrote a revised version of Rondino der Liebenden, which he now called Canzonetta; and a new piece, Valse romantique. These were first performed in Helsinki at the Finnish National Theatre on 8 March 1911, together with Valse triste. The play was not a success, however, hoping to repeat the success of Valse triste with Canzonetta and Valse romantique, Sibelius immediately published them together, as Op. 62a and Op. 62b respectively. They failed to grab the public's attention the way Valse triste had done.
In 1973, Scene with Cranes was posthumously published, as Op. 44, No. 2, and Valse triste was retrospectively renumbered as Op. 44, No. 1.
Recordings and performances sometimes present Valse triste, Scene with Cranes, Canzonetta and Valse romantique as a unified suite, as it represents the totality of what is known of the incidental music for the two versions of Kuolema, however, this was not Sibelius's intention.