The writers felt that this was the episode where everything gelled for the first time. It set the tone for the rest of the series.
According to the writers, the scene where Dent first sees his new appearance in the hospital was intended to be similar to the live-action film Batman (1989), when gangster Jack Napier (Jack Nicholson) first sees his new appearance as the Joker.
Two-Face was originally going to have a 'Godfather'-like voice.
Grace's name is a modification of Gilda Grace Dent, Dent's wife in the comics.
Kevin Altieri said of the script, "It was better than anything the comics had ever done on that character. I'm pretty notorious for changing scripts, which I don't do with malice, but for a love of the medium. But that script didn't need to be changed very much. There were embellishments I gave to it, like adding the rainstorms to the staging of the psychiatrist's office."