The Resident originated from an unproduced Showtime project called The City, pitched by executive producer Antoine Fuqua and described as a dark medical drama about an idealistic young doctor supervised by a cunning, deadly psychopath senior resident.

Fox purchased the series concept from Showtime in January 2017 and ordered a pilot under the new title The Resident, later giving it a 14-episode first season order in May 2017.

The series premiere on January 21, 2018 aired as a lead-out program following the Vikings-Eagles NFC Championship Game, giving it a huge sports lead-in audience.

Primary filming takes place in and around Atlanta, Georgia, with the exterior and some interiors of the High Museum of Art in midtown Atlanta used as the fictional Chastain Park Memorial Hospital.

Some scenes were filmed at the Blankets Creek Bike Trail in Canton, Georgia, and other footage was shot in Conyers, Georgia, on a production set previously used for Fox's Sleepy Hollow.

Production on the third season was suspended in March 2020 due to the COVID-19 pandemic, which left three planned episodes unfilmed and forced episode 20 to serve as a makeshift season finale.

Bruce Greenwood's character was originally announced as Soloman Bell before being renamed Randolph Bell.

The role of hospital CEO was originally played by Valerie Cruz in the pilot; Moran Atias was then cast for a character named Renta Thorpe, but when Merrin Dungey joined as the CEO (renamed Claire Thorpe), producers repositioned Atias's character as the hospital's head of marketing instead.

The series received mixed reviews, holding a 59% approval rating on Rotten Tomatoes and a 54/100 score on Metacritic for its first season, and was often compared to ABC's The Good Doctor.

The show was criticized by some members of the medical profession, who described its depiction of hospital practices as grossly unrealistic.