Sam Shepard's very successful playwrighting career began in the mid-1960s when his often bizarre and anti-realistic plays were produced in experimental off- off-Broadway theatres such as La Mama and Theatre Genesis at St. Mark's Church m-the-Bowery. The launching of Shepard's playwrighting career is generally attributed to a 1967 review by Michael Smith in the Village Voice. Smith's enthusiastic appraisal of the first two of Shepard's early plays—Cowboys and The Rock Garden (both 1964)—brought the playwright to the attention of mainstream critics and audiences. By 1976, Shepard had more than thirty of these mostly one-act plays to his credit and had become an established cult figure.

With Curse of the Starving Class (1977) and Buried Child (1978), Shepard began producing what are now considered his major plays, works defined by a clear focus on such topics as dysfunctional families and social fringe dwellers These plays, in contrast to his earlier work, also display a more conventional approach to plot and character. His popularity broadened and by the time True West appeared in 1980, many critics felt that Shepard was at the forefront of new American playwrights and, along with other dramatists such as David Mamet, Marsha Norman, and Beth Henley, was defining a new decade of theatre.

While True West represents a continued movement in Shepard's drama toward realistic charactenzation, plot, setting, and dialogue, the play also has touchstones in his experimental days, retaining a number of unusual, fantastical elements—such as the grotesque violence and the startling transformations of its two main characters. Some commentators refer to these later plays as examples of "magical realism" (a literary genre denned by the works of such writers as Jorge Luis Borges and Federico Garcia Lorca) because they begin with realistic characters and situations but gradually acquire more bizarre qualities until they finally seem to fuse realism and fantasy. In many circles True West was hailed as a breakthrough for Shepard, a work in which experimental drama was successfully melded with the more conventional elements of modern theatre. Though True West is one of Shepard's most accessible dramas, it retains the unmistakable signature of his earlier adventurous work.