Nominated for an Academy Award for Best Supporting Actress, Geraldine Page was on screen in only two scenes, with a total running time of approximately eight minutes. When Page was Oscar nominated, she became the first woman to receive seven nominations without a win, a feat also achieved by actors Richard Burton and Peter O'Toole. She would finally win an Oscar on her eighth nomination the next year for The Trip to Bountiful (1985).
The film's closing credits dedication states: "Mickey Rourke's Performance is Dedicated to The Memory of James Hayden 1953-1983". Hayden was an actor friend of Rourke's who passed away around the time this movie was made.
Michael Cimino was asked to direct this film, but didn't think it was a good fit for him. As a favor to the producers, who were on a deadline, he went to New York and did all the preproduction. When they were set to begin shooting, the producers again asked Cimino to direct, but considering the budget, he thought that they needed someone who could work faster than he was used to working. They hired Rosenberg.
According to author Christopher Heard, the movie was originally to feature the first onscreen pairing of Robert De Niro and Al Pacino, playing Charlie and Paulie, respectively. In the end, Mickey Rourke and Eric Roberts played the roles.
Rickie Lee Jones had originally written and recorded an instrumental demo as a theme, but it was rejected in favor of Frank Sinatra's "Summer Wind." The demo, which retained the title "Theme for the Pope" (because of the movie), wound up on her 1984 album The Magazine.