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Desire closes with "Sara", arguably (Bob) Dylan's most public display of his own personal life. An ambitious tribute to his wife, Sara, it is possibly Dylan's only song in which he steps out of his public persona and directly addresses a real person, with striking biographical accuracy. Tim Riley wrote that it was "a fevered cry of loss posing as sincere devotion."

Dylan's marriage was in a turbulent state when he wrote the song. Dylan's estrangement from his wife had led to at least one separation in the previous year. Sara was present at the song's recording session, (on the same day he recorded two other songs that touched on the subject of marriage: "Isis" and "Abandoned Love"). However, In March 1977, Sara Dylan filed for divorce.

In the lyrics of "Sara," Dylan states that he wrote Sad Eyed Lady of the Lowlands (from Blonde on Blonde) for Sara Dylan.