The piece was developed in the late 1980s and was originally titled "The Quilt." It was produced first at the Ohio Theatre in Soho in NYC in 1989, where the new title was adopted, and then again Off-off-Broadway in Manhattan's East Village in February 1990. In 1992, it was produced at the King's Head Theatre in London, where it played for several months. In June 1993, the production was transferred to the Criterion Theatre in London's West End, where it played until July of the same year. The London cast included Miquel Brown, Kim Criswell, Kwame Kwei-Armah, James Dreyfus, Simon Fanshawe and legendary drag queen Regina Fong.
Elegies was again performed in New York City on April 2, 2001 in the Haft Theatre at the Fashion Institute of Technology as a benefit for the Momentum AIDS Project. The cast for that performance included numerous well known performers including Alice Ripley, Emily Skinner, Brian d'Arcy James, Christopher Durang, Mario Cantone, Joe Piscopo and Norm Lewis. The concert was recorded, and the soundtrack was released by Fynsworth Alley in 2001.
On December 1, 2008, there was a West End Gala performance of the show at Soho Revue Bar, produced by Rebel Theatre and directed by Simon Pollard. The cast included Anna Chancellor, David Bedella, Leanne Jones, Les Dennis, Adele Anderson and Debbie Chazen. All proceeds from the performance went to the UK charity Terence Higgins Trust.
In addition to the New York and London productions of the piece, there have been professional productions in Australia, Germany and Israel, among other countries.
In Ireland, the premiere production in Northern Ireland was on 30 August 2010 at The Black Box in Belfast. The production featured a cast of 35 actors and singers, including a special video appearance by Graham Norton. A cast recording was released on 14 December 2010. All profits from the production and the recording were donated to the Rainbow Project. The premiere production in the Republic of Ireland was in September 2010 and was produced by Limerick's Bottom Dog Theatre Company.