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The Mysterious Stranger's .44 magnum is visually identical to the Mysterious Magnum, but deals an unstoppable 9000 damage per shot, making it the most powerful weapon in the game after the debug megapistol.
It has no Pip-Boy- Icon. Within the Pip-Boy interface, it is referred as ".44 magnum".
It cannot be picked up again once dropped out of the inventory, due to a game engine setting that disallows pickup by the player.
If given to an non-player character (with .44 magnum rounds) through the console, they will use this weapon. However, if used by an non-player character other than the Mysterious Stranger, it will not work properly, doing no damage instead of an instant kill.
When it is drawn from the holster, it seems to play the sound that plays when the stranger himself appears in V.A.T.S.
The Mysterious Strangers magnum will not use .44 magnum hollow point, hand load, or special rounds, only .44 magnum.
Bugs
Appears to have negative weapon wear; in other words, the lower the weapon condition the more damage it deals; to the tune of 3000 hit points per 500 rounds fired (or 6 hit points for every single round fired).