The album cover is a graphic picture of member Bushwick Bill in the hospital. Bill had shot himself in the eye after his girlfriend refused to shoot him during an altercation.  The other two Geto Boys members and the group's management team took Bill out of the hospital room in order to take the picture, removing his eyepatch and intravenous drip in the process. Bill has expressed regret over the album cover, saying "It still hurts me to look at that cover because that was a personal thing I went through... I still feel the pain from the fact I've got a bullet in my brain... I think it was pretty wrong to do it, even though I went along with the program @ 1st"