The piece is a set of 24 variations on the twenty-fourth and last of Niccolo Paganini's Caprices for solo violin. Several other sets of variations on these theme have been written, including pieces by Johannes Brahms, Franz Liszt and Paganini himself.
Although Rachmaninov's work is performed in one stretch with no breaks, it can been seen as being in three sections, corresponding to the three movements of a concerto: up to variation 11 corresponds to the first movement, variations 12 to 18 are the equivalent of a slow movement (with variations 14 and 15 as a sort of scherzo-interlude), and the remaining variations make a finale.
Unusually, the first variation comes before the theme. The slow eighteenth variation is quite famous and is often included on compilation CDs or records on its own, without the rest of the work. The piece is one of several by Rachmaninov to quote the dies irae plainchant melody (it has been suggested that this is a reference to the legend that Paganini sold his soul to the Devil in exchange for his violin-playing skills).
Rachmaninov himself, a noted interpreter of his own works, played the solo piano part at the piece's premiere in Baltimore, Maryland on November 7, 1934. He was accompanied by the Philadelphia Orchestra conducted by Leopold Stokowski.
In collaboration with Rachmaninov, the choreographer Michel Fokine created the ballet Paganini using this piece as the score. It was premiered in 1939.