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The series was given a pair of consecutive Peabody Awards: in 1991–92 for the show's "depiction in a comedic and often poetic way, of the cultural clash between a transplanted New York City doctor and the townspeople of fictional Cicely, Alaska" and its stories of "people of different backgrounds and experiences" clashing but who ultimately "strive to accept their differences and co-exist."

It received a total of 57 award nominations during its five-year run and won 27, including the 1992 Primetime Emmy Award for Outstanding Drama Series, two additional Primetime Emmy Awards, four Creative Arts Emmy Awards, and two Golden Globes. The series was created by Brand-Falsey Productions. Critic John Leonard called Northern Exposure "the best of the best television in the past 10 years." Simon Pegg has stated that the series was one of the influences on the British sitcom Spaced.

The show started as an eight-episode summer replacement series on CBS in 1990. It returned for seven more episodes in spring 1991, then became a regular part of the network's schedule in 1991-92, where it was among the top 10 among 18 to 49-year-olds, as well as in 1992-93, and 1993-94. Its last season, 1994-95, included a gap during May 1995 sweeps when CBS broadcast other programming.

Northern Exposure began with a focus on Joel Fleischman as an audience-identification character for urban "lower 48" viewers, with storylines revolving around his fish-out-of-water difficulties adjusting to Alaska, and his hot-and-cold romantic involvements with Maggie O'Connell. As Northern Exposure DVD continued, supporting characters such as Chris, Ed, Holling, Shelly, Maurice and Ruth-Anne (along with recurring characters such as Adam and Eve, Barbara Semanski and Bernard) received more development.

Rob Morrow (Joel Fleischman) and his representatives spent much of Seasons 4 and 5 lobbying for an improved contract[citation needed], and intermittently threatened to leave the show. The producers responded by reducing Fleischman's role in the storylines, and introducing characters such as Mike Monroe (season 4) and Dr. Phil Capra (season 6) to partially compensate for the absence of Morrow.