The album cover uses simplistic colors like red, brown, and white to emphasize hidden meanings and distance the band from the album's themes of madness. The front cover features two characters - one dressed as a bear carrying the other - representing the "madness shared by two" described by the album's title, Folie à Deux. Throughout the album packaging, the use of font, color schemes, and imagery continue connecting elements to the idea of a madness that is spreading and taking over.