Miscellaneous items, commonly abbreviated as misc. items, are wearable items with their own 'Misc' section in the loadout screen, though they count as headgear for crafting purposes. Like most hats, they have no effect on gameplay and exist for cosmetic purposes only. As they occupy their own equipment slot, they can be worn in conjunction with hats. Misc. items are either unlocked through achieving certain requirements, dropped during in-game playtime or, for certain misc. items, purchased from the Mann Co. Store.Valve announced in the June 30, 2011 blog post that there would soon be more than one misc. slot, and that it would be possible to wear multiple misc. items. The second slot went live in the beta on September 21, 2011 Patch (Beta), and in the main game on October 13, 2011 Patch.

Currently, there are a total of 264 miscellaneous items.