Cruel Death: An Epitaph, written in the summer of 1874, may be considered unique among Mussorgsky's songs. It is one of the few songs for which he wrote the text himself, one of the few songs dedicated to a woman, and one of the very rare occasions in all his music in which he reveals his own feelings.

The text is painful to read: it opens with "Cruel death like a vulture's talons attacked your heart and killed you" closes with "No, I cannot...I cannot go on..." Mussorgsky wrote the text and the song "for the death of N. P. O...ci...noi...," Nadezhda Opochinina, whom the biographer M.D. Calvocoressi described as "in all likelihood the only woman he ever really loved." Mussorgsky had lived in her house for a period of time in the early 1870s, but never discussed his relationship with her with his friends. In fact, this song is the only expression of his feelings for her. Nevertheless, judging by the powerful emotions expressed in the text, one would guess that, whatever the nature of their relationship, the 35-year-old composer cared very deeply indeed for the woman 18 years his senior.

To the listener, the music itself is more painful than the text. Cast in three sections—a dark opening marked Lento Cantabile depicting death, a gorgeously lyrical central section marked Con delicatezza depicting the beloved's "serene image," and a heartbroken closing Moderato depicting the composer's sense of irrevocable and irreparable loss—Mussorgsky's music for Cruel Death is as excruciating and agonizing as the death scene from Boris Godunov. Cruel Death: An Epitaph was written while the composer was engaged with Pictures at an Exhibition, his memorial to his friend Viktor Hartmann with its disturbing "Talking with the Dead in the Language of the Dead" section. He was also at work on his despairing and hopeless Sunless song cycle, a collection that stands just this side of suicide in its final song, "On the River." Like these contemporary works, Cruel Death gives an all-too-clear view of the composer's tormented soul.

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