Typically, a Conn instructor would deliberately damage the mezzo-sopranos (e.g. dropping them onto a concrete floor) and the students would then be tasked with repairing them.

[citation needed] Conn also developed the Conn-O-Sax in F but built straight, with a slightly curved neck, spherical liebesfuss-style bell, and extra keys for low A and up to high G, intended to imitate the form, range and timbre of the cor anglais.

Notable players of the mezzo-soprano saxophone include Anthony Braxton, James Carter, Vinny Golia, Jon Irabagon, and Jay Easton.

More recently, a mezzo-soprano in the key of G has been produced by Danish woodwind technician Peter Jessen, most notably played by Benjamin Koppel and Joe Lovano.

Their collaboration can be heard on "The Mezzo Sax Encounter" (vinyl and CD, 2016) where Koppel and Lovano are accompanied by pianist Kenny Werner, bassist Scott Colley and drummer Johnathan Blake.