Composition and lyrics
"Sid [Wilson, DJ] came up with this great beat, so we tried to come up with riffs around it. The last thing we added was that chorus… We got Grammy nominations for 'My Plague' and 'Left Behind', which was pretty weird. People were telling me it was a big deal. I was like, 'Is it?' If the people that nominated us had ever seen us, they would have run a mile." – Corey Taylor
"My Plague" is one of the more melodic songs on Iowa, while still featuring many heavier elements. For Billboard, Eric Aiese described it as "catchy enough to pick up some spins at rock radio", noting that it features both "intimidating" and "melodic" vocals. British music magazine Kerrang! highlighted it as an "immensely heavy track but ... with an incredibly catchy and melodic chorus amid the sick riffs and thunderous percussion." Metal Hammer writer Luke Morton claimed the track is "one of Iowa's more accessible songs due to the clean vocals"; adding, "it stills carries that threatening edge like the rest of the record". Victoria Segal of the NME called the song "filthy noise", while E! Online's review of Iowa describes it as "surprisingly melodic". Rolling Stone identified "My Plague" as an example of the "opposition" of "emotional negativity" and "perversely hook-heavy writing" on the album.