This is the last instrumental work Handel completed before he became blind, yet there is nothing elegiac or tragic about this music. Indeed, the work opens with echoes of the "Hallelujah" chorus from Messiah, music as affirming as can be. Interestingly, this motif didn't appear in Handel's original version of the concerto; he refashioned the entire first movement to work it in. The concerto was first performed on March 1, 1751, on a program with The Choice of Hercules and Alexander's Feast. For all the notice given the "Hallelujah" motif in the opening Allegro, that constitutes only the first two phrases of the main theme. The remainder of the theme mainly toys with the motif's rhythm, and only secondarily with its pitch and chord sequences. A stuttering, down-sliding figure sets off each ritornello section, and this figure eventually forms the basis of a section of its own. The second movement, assumed to be an Adagio, Handel left to the organist's imagination. Today's performances generally adapt a slow movement from some other Handel work. The main theme of the Spiritoso isn't Handel's at all; it's lifted from a mass by Habermann. Handel initially toys with the idea of turning it into a fugue, but immediately drops that idea and reverts to his usual pattern of having the organ develop the theme's possibilities in alternation with the orchestra. The concluding Minuet was originally a rather dainty piece introduced by the organ, then fortified and carried to its conclusion by the orchestra, with the organ never again appearing in a solo capacity. The version printed posthumously in 1761 replaces this with a minuet for orchestra alone; today's organists resist sitting out the finale, and generally revert to the original minuet whenever possible.

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