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"Midnight Rambler" was released on their 1969 album Let It Bleed.
The lyrics take the point of view of a roaming rapist/murderer; some of the words are reportedly quotes from Albert DeSalvo's confession to the Boston Strangler's crimes. Keith Richards has called the number "a blues opera".

On the composing of the song, Mick Jagger said in a 1995 interview with Rolling Stone, "That's a song Keith and I really wrote together. We were on a holiday in Italy. In this very beautiful hill town, Positano, for a few nights. Why we should write such a dark song in this beautiful, sunny place, I really don't know. We wrote everything there -- the tempo changes, everything. And I'm playing the harmonica in these little cafes, and there's Keith with the guitar."

When asked about the song in a 1971 interview with Rolling Stone, Richards said: "Usually when you write, you just kick Mick off on something and let him fly on it, just let it roll out and listen to it and start to pick up on certain words that are coming through, and it's built up on that. A lot of people still complain they can't hear the voice properly. If the words come through it's fine, if they don't, that's all right too, because anyway that can mean a thousand different things to anybody".