William Primrose approached Bartók in 1944, after the success of the Concerto for Orchestra, asking for a viola concerto and making clear that he wanted a genuinely difficult piece. Bartók was living modestly in an apartment on Manhattan's Upper West Side and had been diagnosed with leukaemia. He worked on the concerto in the last months of his life and left it in draft; his pupil Tibor Serly prepared the performing version, and later editors have proposed different readings of the sketches. Primrose gave the first performance in Minneapolis in 1949.