This chorale prelude consists of two small organ versets on the Lutheran chorale Ach Gott und Herr. It would have likely been played in alternation with the choir or congregation singing various verses of the chorale tune. The text of the chorale deals with the subject of confession. Verses 1 and 3 best encapsulate the religious theme of sin and redemption highlighted in this chorale: 1—"Ah my Lord God, how heavy and great are the sins I've committed! There is no one to be found on earth that can help." 3—"I call to Thee, Don't reject me although I deserve rejection. Ah God, don't be angry, don't judge me, Thy son has redeemed me."

Buxtehude sets the first verset with the chorale melody appearing un-ornamented in the tenor. In the second verset the chorale melody appears in the soprano ornamented enough that sometimes the melody is difficult to trace. The ornamentation style resembles that of Franz Tunder and Matthias Weckmann and other composers of the previous generation. While there is little concrete information to date Buxtehude's organ works, the style of this works suggests that Ach Gott und Herr was among his earlier works.

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