The idea for the 32 "D'oh!"s in a row footage was from David Silverman's montage that he had assembled for his traveling college show.
The network censors initially refused to let the phrase "beer causes rectal cancer" into the show. The censors eventually relented when they found a medical textbook which stated the link between beer and cancer, but still asked them to "go easy" on beer in the future.
The moment when Barney smothers Homer with a pillow and uses a water fountain to smash through a window is based on the ending of One Flew Over the Cuckoo's Nest. The character who does this in the film is Big Chief, who was also referred to in a gag in Stark Raving Dad.
There was intense pressure on producers of the show to create extra episodes in each season and the plan was to make four clip shows per season to meet that limit. However, writers and producers felt that this many clip shows would alienate fans of the series. The Fox network's reasoning was that clip shows cost half of what a normal episode cost to produce, but they could sell syndication rights at full price.
In 2015, Al Jean reacted to a hypothesis that Homer is still in a coma and all episodes since this one have been imaginary, hence a perceived surrealism and frequent guest appearances. He said that the hypothesis belongs in the "intriguing but false file".