He originally titled it A Tangled Skein. After many rejections, he eventually saw it published by Ward, Lock & Co. in Beeton's Christmas Annual 1887 for which he received £25 in return for the full rights (although Conan Doyle had pressed for a royalty instead).
The story, and fictional character, attracted little public interest when it first appeared. Only ten copies of Beeton's Christmas Annual 1887 are known to exist now and they have considerable value.
The novel was produced in book form in July 1888, published by Ward, Lock & Co. This book was illustrated by Arthur Conan Doyle's father, Charles Doyle. A second edition appeared the following year and contained illustrations by George Hutchinson, and J. B. Lippincott Co. published the first American edition in 1890. Numerous further editions, translations and dramatisations have appeared since.
The novel is split into two quite separate halves. The first is titled Being a Reprint from the Reminiscences of John Watson, M.D., Late of the Army Medical Department. This part is told in first person by Holmes' friend Doctor John H. Watson and describes his introduction to Sherlock Holmes through a mutual friend and the first mystery in which he followed Holmes' investigations. The mystery revolves around a corpse found at a derelict house in Brixton, England with the word "RACHE" scrawled in blood on the wall beside the body.
The second half of the story is called The Country of the Saints and jumps to the United States of America and the Mormon community. It is told in a third person narrative style before returning in the last chapter Watson's account of Holmes' investigation and his solution the crime. In this chapter the relationship between the two halves of the novel becomes apparent. The motive for the crime is essentially one of lost love and revenge.
There are several minor inconsistencies in the story which are incompatible with later Sherlock Holmes stories. Dr Watson provides a short autobiography of himself at the start. In this he is invalided out of the army after being wounded in the shoulder in the Second Afghan War. In later stories, his wound has moved to his leg.