Minaj debuted this song at the 2012 Grammy Awards with a very odd presentation. Billed as "The Exorcism of Roman," the performance featured Minaj in character as her alter ego Roman Zolanski, confessing to a priest before being chained to a wooden board as if possessed by the devil. Eventually the Queens MC began levitating over the stage during the simulated exorcism. Finally, Minaj's alternate persona, Roman's unseen mother Martha, tells him, "Take your medication, Roman, take a short vacation, Roman. You'll be okay."
Minaj explained the Grammy performance to Ryan Seacrest saying, "I had this vision for Roman [Zolanski], I had this vision for him to be sort of exorcised - or actually he never gets exorcised - but people around him tell him that he's not good enough because he's not normal, and he's not blending in with the average Joe. And so his mother is scared and the people around him are afraid because they've never seen anything like him."
The performance sparked predictable outcry from the Catholic League and many social media users. Catholic League president Bill Donahue expressed his organization's displeasure at Minaj's offensive portrayal of possession, particularly "the sexual statement that showed a scantily clad female dancer stretching backwards while an altar boy knelt between her legs in prayer." Later on in his statement, he criticized The Recording Academy for allowing Minaj's showpiece, saying, "What is not in doubt is the irresponsibility of The Recording Academy. Never would they allow an artist to insult Judaism or Islam."