What Hurts the Most

CD 1

1. "What Hurts the Most" – 3:21
2. "The First Time" – 4:11

CD 2

1. "What Hurts the Most" – 3:21
2. "Never Meant to Break Your Heart" – 4:28
3. "Let's Love" (Metro Mix) – 5:40
4. "What Hurts the Most" (CD-ROM Video)

The music video starts with a young girl crying over the loss of her boyfriend. She expresses anger for her father who she blames for making her boyfriend leave, resulting in his demise in a car accident. The girl's very hurt mother watches her daughter's anger for her father and cries as she feels helpless over this unfortunate situation. Over the course of the video, there are scenes of the band playing, flashbacks of the couple, and the girl trying to go about her life. A scene in which with the girl is vomiting in her bathroom and holding her stomach implies that she became pregnant right before her lover's death. The video ends with the girl running up to the boy's wooden cross memorial on the side of the road, to kneel down and say that she saw him, answering his question asked earlier in the video "What do you see?" when they were talking about the future, while a storm is brewing. The music video was directed by Shaun Silva in early 2006.

Rascal Flatts' version of the song is set in the key of F minor, with a vocal range of E♭3-C 5. The main chord pattern is Fm-D♭-A♭-E♭.[8]

From Me and My Gang liner notes.[9]

• Tim Akers – keyboards
• Jay DeMarcus – bass guitar
• Paul Franklin – steel guitar
• Dann Huff – guitars
• Charlie Judge – keyboards
• Gary LeVox – lead vocals
• Chris McHugh – drums
• Joe Don Rooney – guitars
• Jonathan Yudkin – fiddle, banjo

In 2007, German Eurodance trio Cascada recorded a cover of "What Hurts the Most" for their second studio album, Perfect Day (2007). The cover was produced and recorded by band members Yanou and DJ Manian at Plazmatek Studio Cologne in Cologne, Germany. The song serves as the first single from Perfect Day (2007). It was first released in Sweden on November 21, 2007, in digital and physical formats, through Zooland Records.[25] The song was later released in the United Kingdom as a digital single on December 3, 2007, and as a CD single a week later, through All Around the World. The releases featured remixes by several disc jockeys, including Darren Styles, Spencer & Hill and Flip & Fill.[26] "What Hurts the Most" was solicited to mainstream radio stations on December 11, 2007, in the United States, following its digital and physical release within the two weeks before. In Germany, the cover was released as a CD and digital single on January 4, 2008, through Zeitgeist.

In contrast to the original version, Cascada's cover of "What Hurts the Most" deviates from the country sound and replaces it with Europop electronic beats and elements typical of DJ Manian and Yanou productions.[27] However, the song opens with an acoustic guitar playing and Horler's vocals being reverbed by electropop synths.[27] Sharon Mawer of AllMusic noted that despite the heavy electronic beats, lead singer Natalie Horler's vocals are never dominated by the music.[27] According to the digital music sheet published at Musicnotes.com by BPJ Administration, the song is composed in a key of F♯ minor while carrying a tempo of 144 beats per minute. Horler's vocals range between a high register of A₃ to a low register of C♯₅.[28]

Alex Fletcher of Digital Spy gave the song a three-star rating, saying that "it's not as good as previous single 'Everytime We Touch' for sure, but its teasing, lucid intro, which bursts into the hand-clap-inducing, hip-swiveling chorus after a flurry of robotic drum beats is certainly a good giggle."[29] Kurt Kirton of About.com named it one of the album's standout tracks.[30] Chuck Taylor of Billboard gave "What Hurts the Most" a positive review, writing that "this track is remixed into a frothy uptempo anthem, complete with requisite percussive thump and an exulted vocal (with 12 mixes in all) that leaves the lyric's potential heartbreak in the dust." Taylor ended his review, asking "Wouldn't it be wondrous if American programmers renewed their vow in 2008 to put variety on the airwaves—or do we really need a fifth entry in the top 10 from T-Pain?"[31]

In Sweden, Cascada's cover of "What Hurts the Most" debuted on the Swedish Singles Chart on November 22, 2007, at number five, where it peaked.[32] The song fell to number eight the next week, where it stalled on the chart for three weeks.[32] On December 13, 2007, the song debuted and peaked on the Irish Singles Chart at number six.[2] In the United Kingdom, the song debuted on the UK Singles Chart at number 16 on December 9, 2007.[33] In the following week, the song reached a peak of number 10.[33] It exited the chart at nineteen weeks, logging its last week at number 85.[33] On March 22, 2008, the cover debuted and peaked on the French Singles Chart at number two. The song fell to number four in the following weeks and eventually fell off of the chart after twenty-seven weeks.

On January 26, 2008, the band's cover of "What Hurts the Most" entered the Billboard Hot 100 at number 95.[34] The song rose to number 80 in the following week.[35] On March 22, 2008, the cover peaked at number 52.[36] The song serves as Cascada's lowest-charting single on the Hot 100 as well as their lowest-charting lead single.[36] Aside from charting on the Hot 100, the song managed to peak at the top of Billboard Hot Dance Club Songs and at number 28 on the US Billboard Pop Songs.[37] Despite its low peak on the Hot 100, the song managed to sell more than 500,000 downloads, earning a Gold certification by the Recording Industry Association of America in October 2009.[38] In Canada, the song managed to peak at number 54 and lasted on the chart for eleven weeks.[39]

The music video for "What Hurts the Most" was filmed in Los Angeles was released on January 24, 2008, to the US digital markets.

The video opens with Horler sitting in a studio apartment living room holding a note saying "I can't sorry". It moves to a scene, that is intercut throughout the video, where Horler is seen performing in front of a lit up brick wall. When the first verse begins, Horler leaves the room to open the door, allowing her friends to enter. One friend sees the note and tears it up in disgust. More friends came into the apartment and soon began partying. After the chorus ends, the video moves to a tattoo parlor, where Horler receives a tattoo. As the second chorus commences, she is against a wall, appearing heartbroken, while her former love interest gestures toward the wall, attempting to try to reach out to her. Scenes of the house party continue to play throughout the rest of the video. Near the end of the second chorus, Horler is sitting against a white brick, with mascara running from her eyes, telling that she was crying. On the wall is a window in which the love interest appears to be frustrated. As the song approaches the last chorus, the house party ends with the guests exiting Horler's apartment. The video ends with Horler opening the door to see her former lover, who exchanges a smile with her, and shutting the door on him, leaving with a smile on her face.

The video opens with Horler sitting in a studio apartment living room holding a note saying "I can't sorry". It moves to a scene, that is intercut throughout the video, where Horler is seen performing in front of a lit up brick wall. The first minute of the video features Horler singing in the living room. As the song approaches the chorus, Horler leaves the room and moves to a secluded room where she is seen crying. In that scene, there is also an opening that shows an image of the protagonist's former lover staring into the opening. After the chorus ends, Horler sits at a tattoo parlor while the artists gives her a tattoo. She is then seen sitting against a wall while the love interest gestures to the other side, attempting to reach out to her. As the video nears the final chorus, Horler is at a house party with her friends, appearing lonely and heartbroken.

• Recorded and produced at Plazmatek Studio Cologne in Cologne, Germany
• Songwriting – Jeffrey Steele, Steve Robson
• Production – Manuel Reuter, Yann Peifer
• Vocals – Natalie Horler