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This film marked Anna Magnani's first Hollywood picture and her first English-speaking role. According to the New York Times reviewer, Tennessee Williams wrote his play with Magnani in mind. When the play opened in New York City, however, she was not available to take the part. On August 10, 1952, New York Times reported that Vittorio De Sica might direct the film version of the play, and an April 11, 1954 New York Times article reported that Pier Angeli would play the part of "Rosa." (Marisa Pavan, who ultimately played "Rosa," was Angeli's twin sister.) According to a July 1954 New York Times item, January Merlin tested for the role of "Jack."
Information in the MPAA/PCA collection at the AMPAS Library reveals that PCA officials initially rejected Williams' play, stating that the story was absorbed with "lust and gross sex" and confused religion with superstition. According to the July 1954 New York Times article, producer Hal Wallis suggested that Williams temper the play's sexual aspects and make a clear distinction between Roman Catholic beliefs and "Serafina's" superstitions. The completed script was then accepted by the PCA.
Hollywood Reporter news items add Flo Vinson, June Smaney, Loulette Sablon and Trini Varela to the cast, but their appearance in the final film has not been confirmed. Some scenes were shot on location in Key West, FL, according to contemporary sources. Magnani won an Academy Award for Best Actress; James Wong Howe won the Oscar for Best Black and White Cinematography; Hal Pereira and Tambi Larsen won for Black and White Art Direction; and Sam Comer and Arthur Krams won for Best Black and White Set Decoration. The film received a nomination for Best Picture and Pavan was nominated for Best Supporting Actress. In addition, the film was nominated in the following categories: Best Costume Design, Editing and Music. Magnani won a Golden Globe award for Best Actress in a drama, and Pavan won a Golden Globe Best Supporting Actress award. Director Daniel Mann also directed the Broadway play, and Dorrit Kelton, Rossana San Marco and Augusta Merighi appeared in both the film and the stage play.