The album cover is based on Ice-T's O.G. Original Gangster (1991), while the album title may be a reference to Dr. Dre's song Still D.R.E.. This album must have been made sometime after the events of San Andreas; where CJ got Madd Dogg back on his feet. This album may be a nod to the cutscene video after playing the mission, End of the Line, where Madd Dogg showed off his golden record to the Johnson family. The front cover of the album shows a Maverick landing on the roof of Madd Dogg's Crib.
In 1998, Still Madd is digitally remastered and released in a new cover that swaps the images of Madd Dogg and his crib on the album's front. This version album can be found in Comrades Bar, Hove Beach and in the South Bohan safehouse amongst a pile of CDs on the floor near the coffee table.