As (breath) moisture collected in the shō's pipes prevents it from sounding, performers can be seen warming the instrument over a small charcoal brazier or electric burner when they are not playing.

Its traditional playing technique in gagaku involves the use of tone clusters called aitake (合竹), which move gradually from one to the other, providing accompaniment to the melody.

A larger size of shō, called u (derived from the Chinese yu), is not widely used, although some performers, such as Hiromi Yoshida and Ko Ishikawa, began to revive it in the late 20th century.

Most prominent among these are Toshi Ichiyanagi, Toru Takemitsu, Takashi Yoshimatsu, Jo Kondo, Maki Ishii, Joji Yuasa, Toshio Hosokawa, and Minoru Miki.

Composer Vache Sharafyan (1966, Armenia) used shō in his composition "My Lofty Moon" scored for five eastern and eight western instruments that was premiered by the Atlas Ensemble in Amsterdam's Muziekgebouw aan 't IJ in 2007.