Alfred Hitchcock utilized some of the actual real-life locations where the events took place including some of the actual witnesses. Among these are the jail cell where the real Manny Balestrero was incarcerated, the caretakers at the country inn and the inn itself, and the sanitarium where Manny's wife was committed. As much as Hitchcock hated filming his movies on location, he felt that authenticity was crucial to this film due to its real-life "elements that are stranger than all the fiction" he had filmed in his movies prior to this.

This movie is one of Martin Scorsese's favorite Alfred Hitchcock movies and was an influence on Scorsese's Taxi Driver (1976).