The lyrics and music were written by Slayer guitarist Jeff Hanneman and are based on Nazi physician Josef Mengele, known as “Todesengel” or “Angel of Death,” who conducted human experiments at the Auschwitz concentration camp during World War II. “Angel of Death” contributed to the band facing accusations of Nazi sympathizing and racism throughout their career, as did their habit of wearing swastikas at photo ops:

This song is linguistically significant for containing the earliest known usage of the word “abacinate” (see that line’s annotation for more info).