Utility items are items that are not not Armor, Clothing or Weapons, but are still equipped by pawns. They offer a variety of different capabilities. One person can wear one utility item. Utility items can be passive like a shield belt, but most give an ability the player can trigger. Most have a certain number of charges before they run out. Some can be reloaded, while others are consumed by use. Some of these are only available if the Royalty DLC is activated.
Unlike apparel, no utility item in the game currently gets tainted and neither does a damaged item cause the "tattered clothing" mood debuff, however the provision for both exists in the game code.