Earache was founded in the late eighties by Digby "Dig" Pearson. In 1985, before adopting the name "Earache Records", Pearson released "Anglican Scrape Attic", a compilation of early hardcore punk and crossover acts (Hirax, Lipcream, Concrete Sox, etc.). The first official Earache release, on vinyl in 1987, and with the catalogue reference MOSH 1, was The Accüsed's Return of Martha Splatterhead. The label's first major release, however, was Napalm Death's Scum. Then, in 1989, Earache released Naked City's "Torture Garden", an LP of 'hardcore miniatures'. Other early records include albums by some of extreme metal's finest bands, regarded as genre-defining classics.
Earache has a number of sublabels, including Wicked World Records, Elitist Records, and the short-lived Necrosis Records and Sub Bass Records.
Later releases include work by Deicide and by Californian rockers Adema, who entered the USA Billboard charts top 200 in April 2005.
Earache has become inextricably linked with the death metal scene in particular, but also released Welsh ragga-metal act Dub War, Nottingham's hardcore techno outfit Ultraviolence, and Mick Harris' industrial/experimental Scorn, each time expanding the boundaries of extreme music, and opening a path that other labels have followed, sometimes with greater success. Earache have signed even more musically adventurous groups such as Ewigkeit in recent years, but the death metal and grindcore with which it made its name still predominates.
The original logo of Earache Records was designed by Jeffrey Walker, vocalist and bassist of the band Carcass.
In early 2007 the label signed a distribution deal with Caroline Distribution. The deal includes both digital and retail distribution of the label's releases.