This item can only be worn around Halloween or during a Full Moon; at other times of the year, it does not appear in gameplay, unless the server has Halloween mode enabled. However, it can be equipped at any time and can still be viewed on the loadout screen even when it is not visible during games.
The External Organ was contributed to the Steam Workshop under the name "The Dark Orchestra".
- The External Organ was added to the game.
- Due to how the textures are set up, this item's appearance remains unchanged when painted.
- An external organ can be defined as any body part visible on the outside of a living being's body (i.e., skin). In this case, however, it is a literal "organ" instrument that is carried on the back of the Pyro (externally).
- External organ also commonly refers to genitalia, referencing the popular speculation about Pyro's gender.