The 1859-O $20 double eagle is an important coin and most examples are lightly struck at the high points of the obverse and at the star centers. High grade pieces are usually prooflike, though eye appeal tends to be problematic for this issue in general. Prominent die clash marks can be seen on the obverse on most of these New Orleans mint coins. With fewer than 100 examples rumored to exist, the 1859-O $20 is rare in all conditions. Most often found in VF and EF grades, but there are an estimated two dozen pieces in AU available with enough searching. Only two Mint State coins have been acknowledged: an MS-60 graded by PCGS and an MS-61 graded by NGC.

The year 1859 marked one of the low points in shipments of California bullion to New Orleans during the Gold Rush era, the Louisiana facility producing only 9,100 doubles eagles that year. The vast majority of these coins were claimed by domestic circulation in the Deep South and, predominantly, west of the Mississippi River. Rare in all grades, survivors number just 50 to 100 coins, the vast majority of which are in grades through EF. The 1859-O is actually the fourth rarest New Orleans Mint double eagle, ranking behind only the legendary 1854-O, 1856-O and 1855-O, and comparing favorably with the equally highly regarded 1879-O. Most of the few AU and Mint State survivors are cleaned or otherwise impaired.

The example to the left was sold by Stack's Bowers Galleries in June 2021, where it realized $102,000.