Originally, it was assumed that the video would be filmed by Kevin Kerslake, who worked on the videos for "Come as You Are", "Lithium", "In Bloom" and "Sliver". However, the band preferred to work with Anton Corbijn.
To create the Technicolor look, the video was filmed in color, printed in black and white and later recolored by hand.
Kerslake filed a lawsuit against the group for using his ideas in the video, but due to the death of Cobain, the process was stopped.
Cobain argued that the writing of "Heart-Shaped Box" was inspired by television programs about children with cancer.
Despite the fact that the song, formally, was not released as a single, it reached the number one in the Billboard Modern Rock Tracks.