Contrary to popular belief, the film is not narrated by Roger Ebert. Vocal impersonator Stephen Stanton provided his talents while mimicking Ebert's distinct sound to absolute perfection. Stanton also voiced Ebert on Robot Chicken (2001).
According to director Steve James, Chaz Ebert objected to filming Roger Ebert's daily throat suction procedure, while Roger wanted it filmed. They filmed it on a day that Chaz was not present.
Steve James also directed the documentary Hoop Dreams (1994), which was Roger Ebert's favorite movie of the 1990s. The title 'Life Itself' comes from Ebert's original review: "A film like 'Hoop Dreams' is what the movies are for. It takes us, shakes us, and make us think in new ways about the world around us. It gives us the impression of having touched life itself."
The original plan for the film was to document the active schedule Roger Ebert maintained despite his illness, including attending screenings, writing reviews and for his blog, and hosting dinner parties with his wife. However, before filming began Ebert suffered a hip fracture that required months of rehabilitation, and he was later diagnosed with a new cancer, meaning the documentary instead became (in part) a chronicle of his final days.