The term heartland rock was not coined to describe a clear genre until the 1980s. In terms of style it often uses straightforward rock and roll, sometimes with elements of Americana and country. Most artists avoided the synthesizers that dominated the electronic rock of the 1980s and placed an emphasis on guitars, with a basic rhythm and blues line-up of drums, keyboards and occasional horn section instruments like a saxophone. Lyrics are often presented in a style that is raspy and unpolished, adding a sense of authenticity. The genre was most strongly influenced by American country, folk and folk rock acts such as Hank Williams, Woody Guthrie, Bob Dylan, The Byrds, Creedence Clearwater Revival, Van Morrison, as well as the basic rock of 1960s garage and the Rolling Stones.
Verses in heartland rock songs often outline narrative stories, particularly of people undergoing hard times; choruses are often anthemic in tone. The genre is associated with rural and blue-collar values, particularly those of the predominantly white working-class regions of the Midwest and the Rust Belt. It has been characterized as a predominantly romantic genre, celebrating "urban backstreets and rooftops", and its major themes include alienation, despair, "unemployment, small-town decline, disillusionment, limited opportunity and bitter nostalgia".