"Miss Otis Regrets" is a song in the blues style, and Porter's wry take on some common lyrical subject matter of the genre, telling the tale of a woman who comes to a bad end after an encounter with a man. But Porter's peculiar twist is that Miss Otis is a polite society lady, and the story of her last evening is told by her servant after Miss Otis has met her demise. In a few compact lines, the servant reveals how, after being seduced and then abandoned, Miss Otis hunted down and shot her seducer, was arrested, taken from the jail by a mob, and hanged. The servant conveys Miss Otis's final, polite, apologetic words to her friends: "Miss Otis regrets she's unable to lunch today."

The song has been recorded by Nat King Cole, Ethel Waters, Edith Piaf,Nancy Wilson, Jose Feliciano, Linda Ronstadt, Ella Fitzgerald, Kirsty MacColl with The Pogues, The Mills Brothers, Bette Midler, John Barrowman, Josh White, Bryan Ferry, The Pine Valley Cosmonauts, Shani Rigsbee, Richard Manuel and others. The title of the Cheers episode "Mr. Otis Regrets" is also, presumably, a reference to the song.

The television adaptation of an Agatha Christie novel, "Marple Mystery: At Bertram's Hotel", opens with the hotel desk clerk repeating the full "Miss Otis Regrets" line to someone on the telephone.

The song is also played in a South African film called 'Black'; sung by Marley Cooper in a night club. The film noir is due for release in late 2008.

Hungarian author Jenő Rejtő also refers to the song in his novel "Vesztegzár a Grand Hotelben."

The song is also referenced in the number "I Hate Musicals" from Ruthless! the musical.

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