Producer Phil Ramone described the song as being "philosophical and dark." The lyrics of "Laura" depict the singer as being co-dependent on a woman named Laura. Musicologist Walter Everett describes Laura as being "an aggressive woman who traumatizes the singer." He can't resist taking her phone calls, even though he knows she is trouble and that his efforts to help will only lead to more problems. She calls him in the middle of the night and pushes his emotional buttons. According to music critic Mark Bego, Laura appears to be a friend, as the lyrics such as "Living alone isn't all that it's cracked up to be" seem to imply that the singer is reflecting on how his "newfound bachelorhood isn't as much fun as he had hoped it to be." In his frustration with Laura, Joel inserts an f-bomb into the lyrics, surprising listeners who regarded Joel simply as a balladeer. Essayist Chuck Klosterman interpreted the lyrics as Laura "is slowly killing the narrator by refusing to end a relationship that is clearly over. Klosterman interpreted the song as being sung by a narrator who is not intended to be Billy Joel himself who has a life that seems to be perfect even though he harbors a dark secret in his emotionally "exhausting" relationship with Laura, who may be an ex-wife. The song contains the offensive word "fucking" in the middle eight, the only such occurrence of the word in any of Joel's lyrics.

At the time of its release, Joel stated that "Laura" was not written about his own ex-wife, or about a girlfriend. He stated that it is about "the guilt you get from someone in your family who knows just how to stick the knife in and wear you down." He went on to generalize the theme by stating that "You'd be surprised how many people have a destructive relationship and don't know it. Nobody has a right to do that to you; it's against the law. Joel's drummer Liberty DeVitto eventually disclosed that "Laura" was actually written about Joel's own mother Rosalind. DeVitto suggested that the title "Laura" was chosen because it has two syllables, just like the word "mother" does. According to Klosterman, Joel confirmed the fact that "Laura" was about his mother in an interview with him, and that Joel noted in the interview that the line in the song "How can she hold an umbilical cord so long" should have been a giveaway. Joel later stated that he "must have been pretty fed up with some of [his] own mother's manipulation by the time [he] wrote the song, as evidenced by the F-word in the lyrics."

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