“How You Alive” was initially previewed by Trippie Redd in an Instagram live during April 2018, where he would freestyle over the track’s instrumental. Years later following the seemingly-lost snippet’s preview, in 2023, it was re-recorded. On July 16, 2023, it was teased with new vocal takes on Instagram, and on July 24, 2023, A Love Letter To You 5’s tracklist was unveiled via another Instagram post.