The book was rejected for publication in 1925, due in part to the influence of Lev Kamenev, then a leading Party official. Bulgakov subsequently wrote a play based on the story in 1926 for the Moscow Art Theater. However, the play was cancelled after the manuscript and copies were confiscated by the secret police, or OGPU. Eventually, Maxim Gorky intervened to get the manuscript returned.
The story was published in the Soviet Union only in 1987, more than 60 years after its completion, but was made known to Russian readers via samizdat. In 1968, it was published in English by Harvill Press, translated by Michael Glenny.
One suggestion for the real life prototype for Professor Preobrazhensky is a Russian surgeon Serge Voronoff who was famous for his experiments on implanting humans with animal's testicles and thyroid glands, though there were others who did similar work. Another suggestion is professor Vasily Preobrazhensky, who headed the St. Petersburg Institute of Obstetrics and Gynecology at the time the novella was written. His first scientific publication was about the transplantation of ovaries to males. Like the fictional professor, he "did not like the proletariat", and possibly for this he was banished to Arkhangelsk, where he continued his work, including transplants of ovaries, with a hearsay report of short-term rejuvenation effect.