"Didn't We Almost Have It All" received positive reviews from the music critics, who praised it lyrics, production, and Houston's vocal performance. It became Houston's fifth consecutive chart topper on the US "Billboard" Hot 100, staying there for two weeks and also reached the top 10 in various countries. A live performance from her September 2, 1987 concert in Saratoga Springs, New York was used as the official video and played on MTV, VH1, and BET. The recorded performance was also televised along with her performance of "I Wanna Dance with Somebody" at the 1987 MTV Video Music Awards on September 11. At the 30th Annual Grammy Awards, it received a nomination for the Song of the Year.