Otto's Shrunken Head opened in 2002 and is a tiki-meets-punk bar on Manhattan's Lower East Side. Live music acts play regularly in the back room. The music styles range from rock to metal to exotica, and it's often loud. The front entry of the bar has cases filled with tiki mugs and knick-knacks. Over the bar is a row of pufferfish lamps. There are carvings by Wayne Coombs and Crazy Al. Drinks are served in mugs that are available for sale, including a custom shrunken head mug.

In late 2010 a fire damaged the back room of Otto's, but repairs were able to be made swiftly.