"Who Really Cares (Featuring the Sound of Insanity)" is a song by Powderfinger from their sixth album Dream Days at the Hotel Existence. It is the fourth single from the album and was released in Australia in March 2008. The band's publicist, Ms. Fanclub, announced on 27 February that the single would be released to radioplay in the following week, without specifying a date. In her announcement, she also noted that a music video will be released at about the same time. The music video was then released in mid-March; however, the single's release was then announced as 31 March.

A music video was released for the song; however, it features the live version of the song taken from the DVD for the Across the Great Divide tour, whereas the radio single for the song is a radio edit of the studio album version. The music video is directly taken from the DVD; however, it is altered optically with filters and converted into black and white.

"Who Really Cares (Featuring the Sound of Insanity)" was recorded by Powderfinger for their 2007 album Dream Days at the Hotel Existence at Sunset Sound Studio, Los Angeles, California, in early 2007 with producer Rob Schnapf. The part of the title "Featuring the Sound of Insanity" refers to a sound just after the bridge in which a sitar is played with synthesised effects overlaid. Prior to its release as a single, a live version of "Who Really Cares" appeared on the earlier Dream Days at the Hotel Existence single, "I Don't Remember". Another live version also appears on the group's 2007 DVD Across the Great Divide tour.

Though the single was never a physical CD release, artwork was created for it. The artwork featured the headless man who is otherwise seen throughout the releases for other singles from Dream Days at the Hotel Existence, however on this cover, the area where his head would be is a fireball, and he appears to be holding a briefcase while walking down the hallway of a hotel, another common theme throughout the artwork for the album. Unlike the last two singles from Dream Days at the Hotel Existence, the artwork doesn't follow the picture-in-picture theme.

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