Although it did not sell enough copies to reach the mainstream music charts, the album was well received with positive reviews and recognition. Kool Keith's lyrics and Nakamura's production were highly praised, as was DJ Qbert's innovative scratching. "Dr. Octagonecologyst" has since been ranked as one of the best hip hop albums of the 1990s. The character of Dr. Octagon has also appeared in Kool Keith projects like "First Come, First Served" (1999) and "Dr. Dooom 2" (2008), both of which contain tracks in which Octagon is murdered by Dr. Dooom. Kool Keith later stated that the album sold around 200,000 copies without any major promotion or marketing budget.