Al Pacino was initially interested in playing the title character, and worked with the producers on developing the script. However, Pacino ultimately dropped out of the project, due to script problems. Pacino felt, despite numerous revisions, they had never been able to transcend the script's B-movie qualities.
In an October 1, 1989 interview with The Philadelphia Inquirer, Walter Hill said: "I kept turning it down. No studio wanted to make it, and I didn't think any actor would be willing to play it. I wasn't sure the audience would buy the gimmick of the plastic surgery. It's an old-fashioned melodramatic device. Then about a year ago, I decided to do it. First, I figured that Hollywood is based on melodrama anyway and, second, I thought up a way to present the story in a way that resisted histrionics. More importantly, I found an actor who could play Johnny and not make it risible. Someone who understood the pitfalls of the thing. The main thing is that motion pictures have conditioned us to expect psychological realism. This is a drama in a different category. It's about moral choices. I knew I was on very thin ice. If you let any histrionics in, it will fall apart. You have to trust the drama of the whole rather than an individual scene. And that's antithetical to most actors. They want to know, 'Where's my big moment? When do I get to cry and scream?' Mickey understood that."
The movie is considered to be in the "film noir" genre. Walter Hill once said in an October 1, 1989 interview with The Philadelphia Inquirer: "This is very reminiscent of the kind of film noir they made in the '40s. You have the doomed character, and audiences back then were more comfortable with it. You can imagine John Garfield having a lot of fun with something like this."
Three taglines of John Godey's source "The Three Worlds of Johnny Handsome" book were: "A Novel of Suspense", "A High-Tension Suspense Stunner" and "He was an ex-con from nowhere - with a plan for a million dollar hit."
The trivia item below may give away important plot points.
Ellen Barkin said she wanted to play her role, because her character, Sunny "is one of the great female villains. I don't know if I've ever seen a female villain so evil. Sunny's just mean, that's all there is to it, and the great thing about Sunny, in this movie, is they just let her be bad. With women, they always want to give explanations: she had such a terrible childhood or something. They can't just let women be bad. Sex is just one of the tools Sunny uses to get what she wants, and what she wants is money! Pure greed!"