Ulf Björlin was hired to compose original music, however director Bo Widerberg was not happy with the result and it wasn't included. In a last minute decision Piano Concerto No. 21 by Wolfgang Amadeus Mozart was chosen as the main theme - the concerto is since known by the anachronistic nickname "Elvira Madigan".
To accentuate Elvira Madigan's mixed descent her Swedish voice was dubbed by Danish actress Yvonne Ingdal, while Swedish actress Pia Degermark who acted the role dubbed the few scenes where she spoke Danish. This meant she always spoke with an accent.