The miniseries adapts Edward St Aubyn's semi-autobiographical Patrick Melrose series of novels, with all five episodes written by David Nicholls.

Benedict Cumberbatch not only stars as Patrick Melrose but also produces the series, with his involvement announced in February 2017.

Jennifer Jason Leigh and Hugo Weaving joined the cast in July 2017 as Patrick's mother and father, while Anna Madeley was cast as his wife.

Allison Williams and Blythe Danner joined the production in August 2017.

Filming began in October 2017 in Glasgow, with Edward Berger directing all five episodes.

The series was co-produced for Showtime in the United States and Sky Atlantic in the United Kingdom, with new episodes also streaming consecutively on CraveTV in Canada.

The series holds a 90% score on Rotten Tomatoes based on 69 critic reviews, with critics summarizing it as 'a scathing indictment of British high society's inherited dysfunction, cruelty, and the wealth that enables them. The Crown this ain't.'

In 2019, The Guardian ranked Patrick Melrose 51st on its list of the 100 best TV shows of the 21st century.