Musically and lyrically, the album differed greatly from the band's debut, Pretty on the Inside (1991), which was heavily influenced by punk and noise rock. For Live Through This, Hole sought a more accessible rock sound, focusing more on melody and dynamics and utilizing less of the distortion and experimental touches that dominated their previous record. Lyrically, the album heavily reflected Love's life at the time, her transition into public notoriety, and her role as a wife and mother, as well as articulating a "third-wave feminist consciousness".
The album was extremely well received by music critics, garnering rave reviews and "best album of the year" awards in major periodicals, such as Rolling Stone, Spin, and The New York Times. The album was also a major financial success, selling over two million copies worldwide and going multi-platinum within just a year of its release. It also spawned five singles, including "Doll Parts" and "Violet", with "Doll Parts" reaching number 58 in the Billboard's Hot 100 as well as peaking at number 4 in the top Modern Rock Tracks.
In recent years, Live Through This has often been considered a contemporary classic of alternative rock, as well as one of the greatest albums of all time. The album's title is derived from a monologue by Vivien Leigh in Gone with the Wind (1939).