In a hand-pumped harmonium, the player pushes and pulls a handle back and forth with one hand, which is joined to the bellows that blows the air. Because of this, he or she can only use one hand to play the keys as the oth er has to keep pumping the bellows. Some players can pump enough air with one hand, and then play the keys with both hands, when necessary.

The hand-pumped harmonium was created by Dwakranath Ghose so that the instrument could be played while the player was sitting down on the floor. It is used in India, Pakistan, Nepal, Afghanistan and in other Asian countries as an accompanying instrument in Hindustani classical music, Sufi Music, Bhajan and other devotional music, Qawwali, Natya Sangeet, and a variety of genres including accompaniment to Classical Kathak Dance. Nomadic singers string it and wear it around their shoulders taking part in village fairs and festivals.