According to Brown's band leader Pee Wee Ellis, after a show, Brown called him into his dressing room, where he grunted out the bass line for this song, ordering Ellis to write it down. After finding some paper, Ellis notated the grunts, which were later used on the song.

Ellis, who had a jazz background, was a saxophone player in the band as well. He based the repeating sax riff on the Miles Davis song "So What," which has a similar structure. Next came the contrasting guitar part, which made for a very funky rhythm.

This track can make a credible claim to being the first funk song. Pee Wee Ellis co-wrote the track, merging his jazz sensibility with Brown's R&B. Structurally, the song is very unorthodox, disobeying traditional laws of music, like orderly chord changes. This concept of playing what feels right rather than what was musically correct came to define funk and was a hallmark of Brown's music.

Brown famously asks, "Can I give the drummer some"? on this track, before turning it over to Clyde Stubblefied, his funky drummer. This became one of the most famous lines in his repertoire.

It's the groove that carries this song, but the is a coherent storyline. Brown is telling a girl that he's willing to look past her indiscretions because he's crazy about her. When they kiss, he breaks out in a cold sweat.

Brown based the lyrics and pacing of "Cold Sweat" on his 1962 song "I Don't Care," which contains the lines:

I don't care about your past
I just want our love to last

That song runs a tidy 2:50 at a slow tempo. Brown sped it up for "Cold Sweat."

On the single and album, the song is broken into two parts, with Part 1 running 2:24 on the album and Part 2 at 4:46. The single needed to be more evenly spaced, so both Part 1 (the A-side) and Part 2 (the B-side) run 2:55. The version played on pop radio was Part 1 of the single.

When music went digital, the two parts were combined to make one track running 7:24. Sold at first for 99 cents, this was one of the best values on iTunes.