This is Bartók's own orchestral arrangement, made in 1940, of his Sonata for Two Pianos and Percussion (1937), one of the most widely known works for two pianos today. The instrumentation includes the original two pianos and a percussion section for two players (3 timpani, xylophone, snare drums with and without snares, crash and suspended cymbals, bass drum, tam-tam), augmented by two of each woodwind instrument (flute doubling piccolo, oboe doubling English horn, bassoon doubling contrabassoon), string quintet, and celesta. Essentially, the piano and percussion parts remain as in the original, with the orchestra adding sonic power and timbral color.

The original work was initially composed for the 10th-anniversary concert of the International Society for Contemporary Music (ISCM) and premiered in 1938 with Bartók and his wife performing on pianos. For Bartók, the late 1930s was a period of great productivity, during which he completed masterpieces such as the orchestral work Music for Strings, Percussion and Celesta (1936) and the solo piano work Mikrokosmos (1937). It also marked his last glorious period in Europe before his emigration to America in 1940. This concerto version finally had its American premiere in Chicago in 1943 (the European premiere was in 1942), performed under the baton of Fritz Reiner (1888–1963) with Bartók and his wife at the pianos. This performance became Bartók's last public appearance as a performer.

The movement structure is a three-movement form of fast-slow-fast: the first movement (Assai lento – Allegro molto) with an introduction and sonata form, the second movement (Lento ma non troppo) in ternary form, and the third movement (Allegro non troppo) in rondo-sonata form. Up until the late 1930s, Bartók had explored percussive piano techniques, and in this concerto, as well as in the original sonata, an artistic fusion of piano and percussion is truly realized. Furthermore, Bartók often incorporated mathematical elements into his compositions, and it has been found that the golden ratio is meticulously used in this work. The golden ratio is considered the most beautiful proportion, where a whole is divided into a point that results in a ratio of approximately 0.618:0.382. Bartók applied this ratio throughout the work, from its overall structure and the structure of the introduction to the details of individual melodic figures.