"Affliction" had its world premiere at the 54th Venice International Film Festival on August 28, 1997, and was theatrically released in the United States on December 30, 1998, by Lions Gate Films. The film received positive reviews from critics, who mostly lauded the performances of Nolte and Coburn. At the 71st Academy Awards, Nolte was nominated for Best Actor and Coburn won for Best Supporting Actor. It earned six nominations at the 14th Independent Spirit Awards, including Best Feature.