Andy Black grew up in the Southwestern Ohio city of Cincinnati and moved to Los Angeles at the age of 18. Here, the singer examines his relationship with his hometown and the good and bad times he experienced there. Black explained to Kerrang:
"There's a misconception that all I ever wanted to do was to move to Hollywood. The truth is that I loved where I was from. When I was in high school, I got an opportunity to go to Los Angeles for a couple of weeks and I did discover, 'Oh, this is where I need to be to do music.' When you're young, you're impatient with your dreams; if you want to get out, you want to get out.
This song is a love letter to where I'm from. It's a working class area and very salt of the earth. Now I live in California with my wife and we like it here, but I think I'll always identify as someone who's from Southwestern Ohio, because I don't think something like that really ever leaves you."
That's the voice of Andy Black's grandmother that you hear saying "he's the ghost of Ohio" in the song's outro.
The song was produced by John Feldmann (Blink-182, 5 Seconds of Summer). Feldmann also helmed Black's 2016's debut solo album, The Shadow Side, as well as Black Veil Brides' Wretched and Divine: The Story Of The Wild Ones and Vale records.
The Ghost Of Ohio album also serves as a companion piece to a graphic novel of the same name that follows the titular character in a fictional version of Black's hometown. Black explained that for this song's video he wanted the same feeling as in the novel of "the ghost" haunting his own memories and experiences.
About 30% of the video was shot in Andy Black's grandmother's Cincinnati house which was a place he spent a huge amount of time as a child.