The Mad Pumpkin Heads are not, strictly, a noble order, they are conscripts whose madness has been managed by the simplest possible expedient. The Pumpkin Helm description records the design's intent without ornament : 'An oval helm large enough to cover any head. Very heavy and very hard. The inside of the helm is pitch black, keeping the crazed warrior within from panicking. Perhaps its rather roomy interior also helps alleviate feelings of pressure and claustrophobia.' The wearer is sealed in a private night so they will not see the battle they are fighting.

Their weapon is the Chainlink Flail, 'a spiked iron tube attached by a chain wielded by Mad Pumpkin Heads. Especially large for a flail, wielding it requires more strength than it does dexterity.' This combination, a man who cannot see what he is striking, swinging a weapon too heavy for technique, is the canon's quietest comment on conscript warfare under the Erdtree. The Pumpkin Heads are spread thinly across Limgrave, Caelid's plague-fields, and the Wailing Dunes : the small forts and ruins where Marika's reign needed bodies and did not have time to find their minds.