This is the first South Park episode to win the Emmy award.
This episode is loosely based on the case of Terri Schiavo. She died the day after this episode aired.
This is the first time Kenny's Mom does not wear her signature "I'm with Stupid" t-shirt.
This is Satan's first appearance in 5 seasons. His previous last appearance was in Probably (2000) (although he was mentioned in A Ladder to Heaven (2002)).
The first time since Kenny Dies (season 5) that Kenny's death has been a major plot point.