A piano accordions is esswentially the same as a chromatic accordion but equipped with a right-hand keyboard similar to that of a piano or organ (although the mechanism is more that of an organ despite the name). Felt or rubber is placed under the piano keys to control touch and key noise and is also used on the pallets to silence notes not sounded by preventing air flow.

The first accordion to feature a keyboard was probably introduced in Paris in the 1850s.

Because of its universal note system the production of piano accordions has far exceeded that of any kind of button accordion from the 1920s until the present day.