The song tackled issues of the illegal drug trade, promiscuity and HIV/AIDS. Jarett E. Nolan of BMG noted that "Waterfalls" was the first number one song ever to refer to AIDS in one of its verses. The accompanying music video for the song reflected its socially conscious lyrics. With a million-dollar budget, the video was an MTV staple credited for giving the single much of its success. It stayed atop the MTV Video Monitor chart for over a month, making TLC the first act to ever achieve this feat. The video won four MTV Video Music Awards in 1995, including top honors for Video of the Year. TLC was the first African-American act to ever receive the trophy.