"Rotting in Vain" was first revealed on July 16, 2016 when it received its debut live performance at the Chicago Open Air concert. According to Loudwire's Graham Hartmann, "Rotting in Vain" is "Led by a heavy groove and chaotic atmosphere", which later "spirals into darker realms with Jonathan Davis' tortured vocals". Jon Wiederhorn for Radio.com added that the song features "otherworldly guitar effects, a deep, dark groove ... downtuned, distorted guitars and circular bass lines". Speaking about the inspiration for the track upon its release, Korn frontman Jonathan Davis offered the following insight:
||"Rotting in Vain" was written about being in that black place, being in situations that I don't like in life – be it relationships, or feeling when you're stuck and you're just being abused or you don't like where you're at, and you just sit there and rot. It takes you years and years to figure out how to claw your way out. That's where "Rotting in Vain" came from. I'm just sitting there, fucking dying and letting it happen for years and years and not helping myself to get out of that place. That's the vibe that inspired the song.