Contemporaneous Pretty on the Inside was received with acclaim by many British and American alternative press. In a review by
Edwin Pouncey for
NME, the album was positively compared to
Patti Smith's
Horses, as well as the debut albums of the
Ramones,
Television, and
New York Dolls, and was branded as being in "a class of its own", while
Elizabeth Wurtzel wrote in
The New Yorker that "
Pretty on the Inside is such a cacophony ... very few people are likely to get through it once, let alone give it the repeated listenings it needs for you to discover that it's probably the most compelling album to have been released in 1991."
Simon Reynolds of
The New York Times described the album as "a cauldron of negativity... [the band] grind[s] out torturous sound, vaguely redolent of
Black Sabbath... Ms. Love's songs explore the full spectrum of female emotions, from vulnerability to rage. The songs are fueled by adolescent traumas, feelings of disgust about the body, passionate friendships with women and the desire to escape domesticity. Her lyrical style could be described as emotional nudism."
Jonathan Gold of the
Los Angeles Times similarly noted that the lyrics present "a terrifying emotional landscape, closer to
Kathy Acker novels than to anything you might think of as pop" and praised Love's vocals as "astonishingly expressive" and ranging from "howling rage to the sort of sardonic sneer associated with
the Fall’s
Mark Smith... Whether it wanted one or not, the decade finally has an equivalent of Patti Smith’s
Horses. Play it loud.
Pretty on the Inside is about as pretty as a flayed wound." Gold later commented: "If
Pretty on the Inside were a
horror movie, it would be all the parts that you have to look at through your fingers."
LA Weeklys
Lorraine Ali echoed a similar sentiment about the album's harsh nature, describing it as a "slithering nest of ugly thoughts and horrific admissions too intriguing to pass up." {{multiple image
Spins Daisy von Furth noted a lyrical preoccupation with "the repulsive aspects of L.A.— superficiality, sexism, violence, and drugs. Love is the embodiment of what drives the band: the dichotomy of pretty/ugly ... The pretty/ugly dynamic also comes across in Hole's music ... a song like "Teenage Whore" at first comes across like a ranting noisy rage, but underneath is a surprisingly lush melody."
Melody Maker columnist Sharon O'Connell wrote that the album was "the very best bit of fucked-up rock 'n' roll [I've heard] all year," while Deborah Frost of
The Village Voice called it "genre-defying", taking note of Love's reputation on the album as "the girl who won't shut up ... She is all the things that she should not be, and she shoves it, raw, right in your face." Hannah Levin of the Seattle publication
The Stranger praised the album's production by Gordon and Fleming, stating that "despite
Pretty on the Inside's reputation as an unhinged, raw-sounding debut, a great deal of professional calculation went into putting this record together." In 1995,
Alternative Press magazine ranked the album at No. 74 in their "Top 99 Of '85–'95" list, noting that "Love works in extremes and wears that
scarlet letter when she feels like it, and when she doesn't she rips it off, never neglecting melody and language as the real medium for her message." Wendy Brandes of
CNN, while reviewing Hole's third release,
Celebrity Skin, in 1998, described
Pretty on the Inside as "the musical equivalent of scrubbing one's eardrums with sandpaper".
Retrospective Stephen Thomas Erlewine gave the album a notably mixed review at
AllMusic, calling the album "brutally uncompromising", and further noting: "The jagged white noise and buzzing guitars articulate Courtney Love's pent-up rage as well as her lyrics, and while that might make the album difficult to absorb in one sitting, it also makes it a singular achievement." In a 2015 retrospective assessment,
Spin noted the album's overt
noise rock influences, writing that it "played like
AmRep release". ==Legacy==