Among his four piano concertos, this one is less well-known.

In 1917, Rachmaninoff, having fled the Russian Revolution, settled in New York. Although he yearned to return to Russia in his later years, this wish remained unfulfilled due to the outbreak of World War II and other factors, and he spent the rest of his life in America.

During the 25 years after he moved to America, the number of compositions he produced was very small, and their quality is arguably not superior compared to his works from the Russian period. This concerto is one of the works composed during that period. He began sketching the piece in 1914, and after a nearly ten-year hiatus following his exile, he resumed composition in 1926 and completed the work.

The piece was dedicated to the composer and pianist Nikolai Medtner, who encouraged him to compose it. He, like Rachmaninoff, was one of the musicians who fled Russia.

The version currently performed is the revision from 1938.

First Movement: Allegro vivace (alla breve) in G minor, 2/2 time

Following the opening tutti, the first theme in G minor is played by the piano in double notes.

The second theme in E-flat minor appears in the piano part, following a melody played by the English horn. Although there is no clear boundary between the development and recapitulation sections, elements of the first and second themes are transformed and restated, showing development. The piano largely plays a decorative role in the accompaniment. The coda, marked Allegro vivace, reintroduces a transformed version of the opening material, and the piece concludes powerfully.

Second Movement: Largo in C major, 4/4 time, Ternary form

Following the piano's introduction, the piece progresses quietly with strings and piano alternately playing the theme. In the middle section, a sudden, wild musical idea emerges. In the third section, the theme is treated in a transformed manner. The piece concludes by fading away, accompanied by piano trills.

Third Movement: Allegro vivace in G minor, 3/4 time

Following an introductory idea that begins with sharp orchestral sounds, the piano rushes around with dizzying motion. After the theme is played by the piano and orchestra, a musical idea based on triplets appears. Carried by a bouncy rhythm played by the piano at a tempo meno mosso, the piece builds up to form a climax. It then transitions to a quiet musical idea, with fragmented melodies overlapping and gradually developing. In the coda, various elements from earlier are restated and transformed, and the piece concludes vigorously.