The book was originally to have been published by Simon & Schuster in March 1991, but the company withdrew from the project because of "aesthetic differences". Vintage Books purchased the rights to the novel and published the book after the customary editing process. The book wasn't published in hardcover in the United States until 2012, when a limited hardcover edition was published by Centipede Press, although a deluxe paperback was offered. Ellis received numerous death threats and hate mail after the publication of American Psycho.
In Germany, the book was deemed "harmful to minors", and its sales and marketing were severely restricted from 1995 to 2000. In Australia, the book is sold shrink-wrapped and is classified "R18" under national censorship legislation. The book may not be sold to those under 18 years of age. Along with other Category 1 publications, its sale is theoretically banned in the state of Queensland and it may only be purchased shrink-wrapped. In Brisbane, the novel is available to those over 18 from all public libraries and can still be ordered and purchased (shrink-wrapped) from many book stores despite this prohibition. Bret Easton Ellis has commented on this, saying "I think it's adorable. I think it's cute. I love it." In New Zealand, the Government's Office of Film & Literature Classification has rated the book as R18. The book may not be sold or lent in libraries to those under 18 years of age. It is generally sold shrink wrapped in bookstores. In Canada, the book generated renewed controversy during the trial of serial killer Paul Bernardo after it was discovered that Bernardo owned a copy of the book and had "read it as his 'bible'."
Feminist activist Gloria Steinem was among those opposed to the release of Ellis' book because of its portrayal of violence toward women. Steinem is also the stepmother of Christian Bale, who played Bateman in the film. This coincidence is mentioned in Ellis' mock memoir Lunar Park.