Suzanne Shepherd first read the script while on a train to Baltimore. After discovering the film's content, she became quite upset and did not want to do the film. It was only after meeting John Waters that she agreed to play Big Ethel.
The book David Hasselhoff reads near the end of the film, "Suicide In The Entertainment Industry" is a real book given to John Waters as a gift.
When the MPAA was asked what would needed to be cut to obtain an R rating, they replied that if everything the MPAA objected to was to be removed, the movie would only be ten minutes long. According to Waters, he had been told "after a while, we just stopped taking notes."
John Waters has been quoted as saying that had Divine, his friend and frequent collaborator, still been alive, he would have played the role of Big Ethel.
The line "I was married to an Italian" was, according to John Waters, said to him by Maryland film censor Mary Avara.