Like the Piano Trio No. 2, Op. 67 (1944), the String Quartet No. 4 features thematic elements of Jewish inspiration. But in the postwar era and until Stalin's death in 1953, Shostakovich had become well aware he could not display any obvious sympathies with Jews and Jewish culture in his compositions and thus withheld the work from performance until after the tyrant's passing.

The first movement, marked Allegretto, begins with the viola and cello playing a drone while the violins present the main theme, with Jewish folk music figurations. The music quickly reaches an intense, ecstatic climax, and for the rest of this brief movement (typically less than four minutes' duration), the mood remains subdued. A second theme is heard, followed by a brief development, reprise, and coda, but all these sections have a deliberate sense of anticlimax in their generally dark character. The second movement (Andantino) presents a melancholy waltz, first played by the violin, then by the cello. The music intensifies as the theme is developed in the middle section, but the calmer, somewhat foreboding mood of the opening returns in the closing pages.

The third movement is a muted Scherzo (Allegretto), launched by a driving ostinato from the viola and second violin, over which the cello, then first violin play a sinister melody. A second theme provides contrast in its brighter, livelier character, but cannot dispel the generally anxious, dark mood in this four-minute panel. The finale, despite its Allegretto marking, starts slowly with a sustained viola note held from the Scherzo, over which is presented a somber melody. Soon, however, a theme of decidedly Jewish flavor is presented over a pizzicato rhythm. A second lively theme, also evidently of Jewish inspiration, is heard and both are then developed. The colorful, infectiously rhythmic, and generally bright mood prevails until the sober reappearance of the opening theme, after which the mood turns darker and the music slowly fades, the quartet pessimistically ending.