One average day in Bikini Bottom, Squidward is playing his clarinet when SpongeBob goes outside to do some gardening. He thinks Squidward went to an Italian restaurant called Mario's. Suddenly, SpongeBob notices two construction workers putting up a billboard. Thinking Squidward's music is flatulence, SpongeBob becomes noisy to cover it up until Squidward alerts him to stop. Getting mad at the billboard workers, he then discovers the Bikini Bottom Symphony Orchestra is holding a competition for an original score.
Following a series of events starting with Patrick breaking his butt, Squidward tries not to get distracted by SpongeBob's home doctoring. After turning in his score, he finds that he wrote down all of SpongeBob's doctoring. When it's Squidward's time to perform, He finds SpongeBob squeezing a rubber duck and Patrick going "Woo!" and SpongeBob is on a seat, bashing Patrick's brain, causing a farting noise and making his eyes pop out.
The audience gives a round of applause to Squidward. SpongeBob says to make sure Squidward doesn't get a "swelled head." The camera cuts to only Squidward, whose head inflates due to Patrick squeezing the pump of the blood pressure, and the episode ends by the screen blacking out as an explosion is heard.
When Squidward finally finishes writing his song, he has that same look on his face that he had in the episode "Squid's Day Off," when he locked himself in his house. However, sand was added into his eyes in this episode.
The machine that Patrick was in was exactly like the one SpongeBob was dreaming about the laughing machine in "Funny Pants."
When "The Splinter" premiered, this episode also aired along with it.
In "Suds" and "The Splinter," Patrick pretended to be a doctor and treated SpongeBob. This time, the tables are turned: SpongeBob pretends to be a doctor and treats Patrick.
It is not known because if Squidward needed silence to concentrate, but it never occurred to close the window.
The first time SpongeBob puts on a rubber glove and makes that squeaky sound and Patrick goes "Woo!," may have implied that SpongeBob was giving Patrick a prostate exam. However, he was just playing with a rubber duck that amused Patrick.
Dish Network calls this episode "Suctioncup Symphony."
In Poland, the explosion sound at the end is cut from Nickelodeon airings, but left intact on PULS 2 airings.
The symphony the orchestra plays may have been from Heroes of the Bible: Lions, Shepherds and Queens (Oh My!)
SpongeBob said "Sounds like Squidward ate at Mario's last night." The restaurant "Mario's", a fictional Italian restaurant mentioned in this episode, could be a reference to Mario the popular video game character from the Super Mario Bros. series.
Squidward would have seen "Bikini Bottom Symphony Orchestra" on the billboard since "Original Compositions Wanted" was the part that wasn't visible.
All the music players still continued playing their instruments after the music ended.
In some of the wider shots of the orchestra, Richard A. Bottomfeeder is seen with a yellow body and blue hair instead of a green body and black hair.
When Squidward was dropping SpongeBob and Patrick out of the window, SpongeBob's freckles are missing.