The Real Slim Shady features Eminem performing the song in a psychiatric ward, a local Detroit neighborhood park, a fast-food joint, the Grammy Awards, and even in a factory where multiple clones of the rapper are produced. The video also features cameo appearances by Dr. Dre, D12, Kid Rock, Fred Durst, Carson Daly, Pamela Anderson, Tommy Lee, and even a stuffed Bill the Cat doll can also be seen being held in possession by one of the mental patients in the hospital scenes. Also, Kathy Griffin appears in the video as an attending nurse in a psychiatric ward.
The video also features Eminem dressed in a Robin-like superhero costume with a plastic derrière chasing a group of individuals and pushing one of the individuals on the ground and putting 'his bum on the man's lips.' The costume can be seen later in the "Without Me" music video following the release of The Eminem Show.