The song's title is based on Travis Scott's use of weed. He is so heavily under the influence of the drug he feels like he's the "highest in the room." The hook's final line, "Hope I make it outta here," suggests La Flame is suffering from drug-induced paranoia.
The first verse finds Scott discussing his love for his then-girlfriend, reality-TV star Kylie Jenner. According to TMZ, they called it quits in late summer 2019 (they were last seen together publicly on August 27).
Kylie Jenner first teased the song in April 2019 as part of her Kybrows collection commercial. The following month, Scott performed a truncated version of "Highest In The Room" during his headlining set at Rolling Loud Miami. Then, on September 1, 2019, Scott elected to play a snippet of the record during a live show, which included a verse from Lil Baby. However, Lil Baby's contribution was left off the final version of the song.
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