One of the nice things about Pipsqueak Spire's summit is that you know when you're on it - though there are a whole series of pinnacles along the summit ridge, the highest is pretty obvious. The other nice thing about it is that the highest pinnacle also happens to be the coolest. It looks like a miniature version of Starlight Peak's famous Milk Bottle
The summit can be approached via class 2 routes from the south via Cox Col, or from the north starting at the top of the Hourglass. The north side is a steep talus scramble, not terribly exciting, much like the south slope of nearby Mt. Dade on the opposite side of the Hourglass. The south side can be made very easy from Cox Col by staying on the west side of the connecting ridge. The ridge itself is a highly enjoyable class 2-3 scramble - the more you stick to the ridgeline, the more difficult it becomes.
Trip reports vary in the reported difficulty of the summit block, up to class 5.6. Secor calls it class 5 without further specification. Because it is so short (10') with little exposure, I would give it a class 4 rating. Your opinion will undoubtedly vary.
The block can be climbed from two sides, the southeast and the northwest. The southeast side is the easiest. One stands on a subsidiary flake, putting you just over 8ft from the top. Tall people can reach over the top edge with the right hand for a bomber hold. Others will require a bit more finesse with less certain holds. The exposure here is minimal.
The northwest side features a split in the pinnacle, the dividing crack providing a second way to surmount the block.
If you are comfortable on class 4 terrain, no rope or rock shoes are necessary. At most, a short rope (20-30m) will easily suffice to get you up the summit block. It is easy enough to toss a rope over the top and have a partner provide a toprope belay. The rock is coarse granite with excellent friction, so almost any shoe type will stick.
Even in winter the summit block is snow free. The rest of the route to get there is another matter altogether, and a considerably harder challenge.
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