The Coronation of King George V and Queen Mary on 22 June 1911 was a showcase for music from 400 years of musical tradition, directed by Sir Frederick Bridge, Organist of Westminster Abbey. As well as pieces by Thomas Tallis, Handel and John Merbecke (c.1510-c.1585) several new pieces of music were to be composed by Bridge, Sir Hubert Parry, Sir Charles Villiers Stanford, the organist Walter Alcock and Sir Edward Elgar. This was not the first piece Elgar had composed for a royal event, having produced a hymn ‘O Mightiest of the Mighty’ for King Edward VII’s Coronation, and he was later to dedicate his second symphony to the late King while also composing music for his successor’s Coronation in 1911. The pieces produced for King George V’s Coronation included a new Coronation March, first performed on 24 May 1911, and this anthem 'O Hearken thou', taken from Psalm 5:2-3 and performed during the Coronation itself during the Communion. While the Coronation March received a lukewarm reception on its first performance, ‘O Hearken thou’ was well received, and was immediately published by Novello. The Preface to the Form and Order of Their Majesties’ Coronation described the piece as ‘in every way a worthy example of English music, exhibiting in every line that spiritual intensity so characteristic of the composer. Amongst many striking progressions, the final cadence will be particularly noted, while the impression given by the work is exactly what it should be - a reverent supplication.’

Shortly before the Coronation Elgar was made a member of the Order of Merit, awarded for distinguished service in the armed forces, or in the fields of science and culture, and limited to only 24 members. Regardless of this honour, Elgar declined to attend the actual Coronation, apparently much to the annoyance of his wife Alice.

He retained his autograph of the score for two decades before presenting it to King George V for preservation in the Royal Library in 1932.