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Joel recorded Turnstiles in part as a celebration of his return to his native New York City. Three of the album's tracks reference New York: "Summer, Highland Falls", "New York State of Mind" and "Miami 2017 (Seen the Lights Go Out on Broadway)". It begins with "Say Goodbye to Hollywood" (inspired by The Ronettes song "Be My Baby") and also includes "I've Loved These Days", a tongue-in-cheek expression of regret at leaving behind Hollywood decadence. In an interview, Joel stated that the lyrics to the song "James" referred to various different people he knew in real life, with the title character being a "composite" of those people. In the song "Prelude/Angry Young Man", Joel opens and closes the song rapidly hammering the piano, which was meant to simulate the drum part in the song "Wipe Out" by The Surfaris.
The album cover photo was shot in the Astor Place station on the IRT Lexington Avenue Line of the New York City Subway. According to Joel, each of the characters on the album cover was meant to represent a particular song (e.g., the girl in headphones for "All You Wanna Do is Dance," the wealthy couple for "I've Loved These Days").
Robert Christgau of The Village Voice wrote that Joel's craft improves, but "he becomes more obnoxious: the anti-idealism of 'Angry Young Man' isn't any more appealing in tandem with the pseudoironic [sic] sybaritism of 'I've Loved These Days.'" In a retrospective review, Stephen Thomas Erlewine of AllMusic wrote that "key to the record's success is variety, the way the album whips from the bouncy, McCartney-esque 'All You Wanna Do Is Dance' to the saloon song 'New York State of Mind'; the way the bitterly cynical "Angry Young Man" gives way to the beautiful 'I've Loved These Days' and the surrealistic apocalyptic fantasy 'Miami 2017 (Seen the Lights Go Out on Broadway).' No matter how much stylistic ground Joel covers, he's kept on track by his backing group."
Many tracks have alternate mixes exclusive to the Quadrophonic LP release including "New York State of Mind", "Prelude/Angry Young Man", "I've Loved These Days" & "Miami 2017 (Seen the Lights Go Out on Broadway)".
Contrary to some sources, the sax solo on "New York State of Mind" was never re-recorded by Phil Woods for the release of Greatest Hits. The only time that Phil Woods performed on a Billy Joel recording was the song "Just the Way You Are" in 1977.