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The music box's tune can be changed to be faster or slower, with the red music box being faster and the blue music box being slower. Once a music box is placed, it will effect a fairly large circular area, colored in blue or red, depending on which music box that has been placed down, and with soft music coming from the box. Survivors within the range of a Fast Music Box will have their speed of movement and all interactions increased, but the Hunter will not be affected. Hunters within the range of a Slow Music Box will have their speed of movement and all interactions decreased, and it will not affect survivors. Hunters can break both types of music boxes by stepping on them.

Fast Music Boxes are commonly placed near Cipher Machines or the Exit Gates to increase decoding speed, while slow music boxes are placed in areas used by the survivors to escape the hunter for a longer period of time, such as near pallets or large obstacles.