As Duane Allman's debut does not come until the album's fourth track (the blues standard "Nobody Knows You When You're Down and Out"), "Bell Bottom Blues" features only Clapton on guitar; Clapton compensates for this by overdubbing rhythm and lead parts.
Bell-bottoms are a style of trousers that were popular at the time. According to Clapton, the song was written for Pattie Boyd after she requested him to get her a pair of bell bottom blue jeans from the United States. Clapton wrote the song for her, along with many others on the album such as "I Looked Away" and "Layla". During some tours, he has played the song as part of an acoustic set, such as One More Car, One More Rider. He played the song along with Bobby Whitlock on Later with Jools Holland in April 2000.