[4] This instrument bears a strong resemblance to the "patent clarions" (bass clarinets) made from about 1810 by George Catlin of Hartford, Connecticut and his apprentices.

A few jazz musicians, Hamiet Bluiett, Vinny Golia, J. D. Parran, Petr Kroutil, Joe Lovano and Gianluigi Trovesi among them, have played the alto clarinet.

"[9], while Charles Koechlin describes it as "like the basset horn, a very beautiful instrument" with a "legitimate place [in] a Clarinet Quartet, where it will have the same role as a viola in a string quartet"[10] The alto clarinet band part remains in 20th and 21st century wind band literature.

An important orchestral example is Igor Stravinsky's Threni, which calls for an instrument in F instead of the usual E♭, and with extension keys to fingered low C (therefore indistinguishable from a basset horn).

[16] The solo repertoire for alto clarinet is quite limited, with much of it consisting of transcriptions of works originally for basset horn.

A number of compositions originally conceived for alto clarinet and piano include Franklin Stover's Pastorale & Passepied (with alternate part for basset horn in F), Frank McCartey's Sonata, David Bennett's Dark Wood, William Presser's Arietta, Alfred Reed's Serenata and Sarabande, and a Sonata by Norman Heim.

[17] In contrast with more recent families of instruments such as for example the saxophone, the terms used for the different sized clarinets draw more on tradition and regionalism, and are not without discrepancies.

It is clear that the "soprano" clarinets in B♭, A, and C are perfectly capable of taking on the higher lines in a score, but they achieve this by playing largely in their "clarion" and "altissimo" registers.

Also, since the time of Mozart and the clarinettist Anton Stadler, composers began to favour the rich sonorities of the lower tessitura of the clarinet and this may partly have contributed to the clarinet family being pitched further down against its counterparts in the wind section of the orchestra where it will often take on the lower parts.

[19] Arguments for its removal include its relatively low volume, the superiority of a then-recent (but never mass-produced) prototype in the key of F, and that its part is often doubled by other instruments.

This discourse caused the instrument's popularity to decline, meaning that much music published from the 1970s onwards does not include an alto clarinet part (especially pieces written for developing ensembles).