In the liner notes of Dion's box set King Of The New York Streets, he told the "Runaround Sue" origin story:

"It came about by partying in a schoolyard. We were jamming, hitting tops of boxes. I gave everyone parts like the horn parts we'd hear in the Apollo Theater and it became a jam that we kept up for 45 minutes.

I came up with all kinds of stuff. But when I actually wrote the song and brought it into the studio to record it, well, her name wasn't actually Sue.

It was about, you know, some girl who loved to be worshiped but as soon as you want a commitment and express your love for her, she's gone. So the song was a reaction to that kind of woman."

No Belmonts here - The Del Satins ("In the Still of the Nite," "To the Aisle") backed up Dion instead.

Two years after this song was released, Dion married a woman named Sue.

In a 2009 interview with Blueswax, Dion revealed that his wife tells people this song is about her, even though she knows it isn't. Said Dion: "She goes around telling everybody, 'Yeah, I'm Runaround Sue.' I said, 'Why do you tell people that?' She says, 'They remember me.' She said, 'If I don't tell them that, they won't remember me.'"

Dion started to put the song together at an informal schoolyard birthday party in the Bronx for his friend Ellen. He got everyone to lay down a beat on boxes and bottles and to add doo-wop background harmonies to a clapping rhythm. When Dion came to record the song, he wanted to keep the same informal vibe.

"I remember telling the band, 'No cymbals! I don't want a drum kit, we're just gonna clap our hands," he recalled to Uncut magazine. "Because I wrote it at a party - everybody was banging on cardboard boxes and tables and just hitting bottles. We had a riff going and I sang for like 45 minutes. So when I went into the studio I wanted to keep it primitive."