The game is derived from an original, completely different Japan-only game called Yume Koujou: Doki Doki Panic (1987) ('Dream Factory: Doki Doki Panic'), an Arabian-themed game inspired by a Japanese TV show, with no relation to the Super Mario universe (despite containing many similar elements). The original Japanese Super Mario Bros. 2 (Super Mario Bros.: The Lost Levels (1986)) had only been released in Japan; Nintendo of America had rejected it for being too similar to Super Mario Bros. (1985) as well as too difficult, and not wanting to jeopardize the popularity of the Super Mario franchise in the USA, they had requested a different game. In the meanwhile, director Kensuke Tanabe had experimented with an early prototype game consisting of vertical scrolling, but found it insufficiently engaging and too complex to run on the hardware of the time. He and the Super Mario Bros. team later successfully combined the shelved prototype with horizontal scrolling, and created Doki Doki Panic, describing it as "a full-fledged new Mario". When the request for a different Mario sequel came in, Tanabe decided that he only needed to alter his own Doki Doki Panic game by inserting Mario, Luigi, Toad and Princess as playable characters. This explains why the second game, released in 1988, is so vastly different in design, theme and gameplay from the first. Such was the success of this international Super Mario Bros. 2 that it was also released in Japan in 1992 under the title "Super Mario USA". The original Japanese Super Mario Bros. 2 was finally released in America in 1991, as a part of Super Mario All-Stars (1993) under the title "The Lost Levels".
The title screen music is a remix of the song from the Water levels in the first Super Mario Bros. (1985) game.
First playable appearance of Princess Peach and Toad.
Although the game was not originally a Mario game, many of the foes in this game later became regulars in the Mario series (Shy Guys being the best example). Wart/Mamu, the main villain from this game, did not return in the Mario franchise, but made a cameo in The Legend of Zelda: Link's Awakening (1993) and its remake The Legend of Zelda: Link's Awakening (2019) instead, as a musician.
This is the only Super Mario game where the King of the Koopas, Bowser, did not appear as Final Boss. It was replaced by Wart (Mamu in the original videogame Yume Koujou: Doki Doki Panic (1987) ("Dream Factory: Doki Doki Panic")).