Foreign viewers not familiar with the situation in Romania in the late 1980s may be unaware that not only abortion was illegal there, but contraception as well. In an effort to increase the dwindling population, the dictatorial Communist regime had issued Decree 770 in 1967 which put a ban on not only abortion but also contraceptive medicine. The women in the beginning of the film are obtaining their contraceptive pills illegally through the black market, as well as luxury products like soap and cigarettes.
The "15th Best Movie of the 21st Century" according to a poll by BBC Culture of 177 film critics from 36 countries aimed to find 21st century's top films. Each critic was allowed to submit 10 films, all produced between 2000 and 2016, which resulted in a total of 599 films, which were sorted into the top 100. The resulting top 100 list had 4 Months, 3 Weeks and 2 Days (2007) at No 15.
The 2008 Oscar winner in the 'Best Foreign Language Film' category at the 80th Academy Awards was Austria's The Counterfeiters (2007), an entry much criticized as conventional and artistically inferior to Cristian Mungiu's Palme d'Or winner. The surprising snub of 4 Months, 3 Weeks and 2 Days (2007), which wasn't even nominated, resulted in intense scrutiny and ridicule of the Academy Awards by the international film community and eventually inspired reforms to the 'Best Foreign Language Film' selection process.
Based on real events an old acquaintance told the director.
One of director Gaspar Noé's favorite films: "...one of the best films of the decade [2000-2009], in my opinion, is 4 Months, 3 Weeks and 2 Days (2007), the Romanian film."[2010]