The lyrics of "Angel of Death" delayed the release of Reign in Blood which was originally scheduled for April 1986.[15] The band was signed to Def Jam Records, whose distributor, Columbia Records, refused to release the album due to its subject matter and artwork, which they believed were "too graphic".[2] Reign in Blood was eventually distributed by Geffen Records on October 7, 1986, but it did not appear on Geffen Records' official release schedule because of the controversy.[2]

"Angel of Death" caused outrage among Holocaust survivors, as well as their families and the general public. The controversy led to accusations of Nazi sympathizing and racism which have followed Slayer throughout their career.[2] The band members have denied the accusations, stating that they do not condone racism and are merely interested in the subject.[16] In 1987, Hanneman told the NME magazine:[17]

I feel you should be able to write about whatever you want. Angel of Death is like a history lesson... I'd read a lot about the Third Reich and was absolutely fascinated by the extremity of it all, the way Hitler had been able to hypnotise a nation and do whatever he wanted, a situation where Mengele could evolve from being a doctor to being a butcher.

Hanneman also wrote "SS-3", a song about senior SS commander Reinhard Heydrich, which appeared on the band's 1994 album Divine Intervention.[20][21] The song "Jihad" from their 2006 album Christ Illusion has drawn comparison to "Angel of Death".[22] "Jihad" deals with the September 11, 2001 attacks, telling its events from a terrorist's perspective. Araya expected the subject matter to create a similar backlash to that of "Angel of Death", but it did not materialize[23]—in part, he believes, due to people's view that the song is "just Slayer being Slayer".[24]