Fear Factor was adapted by Endemol USA from the original Dutch series titled Now or Neverland, and served as NBC's answer to CBS's Survivor.

Host Joe Rogan, previously known for NewsRadio and UFC commentary, said in a 2015 interview that he expected the show to be cancelled after a few episodes due to objections to its content, and admitted he mainly took the job to gather material and anecdotes for his stand-up comedy career.

During a tear gas stunt in the third season, the wind changed direction and blew the gas toward Rogan, the camera crew, and contestants who were not even participating in that stunt at the time.

In an unaired moment from the first season, Rogan personally ate three sheep eyes exactly as the contestants had to, feeling it wasn't fair to make them do the first 'gross' stunt of the series alone while he merely watched.

An episode featuring contestants drinking donkey urine and semen was pulled by NBC in 2012 after images of the stunt leaked online, though footage later aired on Danish television in 2012 and Fear Factor eventually posted clips on YouTube in 2014.

In 2004, a Cleveland paralegal named Austin Aitken sued NBC for $2.5 million, claiming that watching an episode involving blended rats made him so disgusted he became dizzy, vomited, and injured himself running into a doorway; the lawsuit was later dismissed as frivolous.

The Edison Electric Institute publicly warned about an episode where contestants climbed through a simulated electrified substation, fearing viewers might attempt the same stunt on a real substation with potentially fatal consequences.

The only time the $50,000 grand prize went unclaimed was in a September 2004 'Best Friends' episode, when no team could complete a final stunt requiring one member to drive a sports car up a ramp onto a truck bed.

Over its original six seasons, Fear Factor reportedly earned NBC around $600 million in advertising revenue, and in 2004 it became the first network reality show to be syndicated.