There's a guy out there who uses Tetris to create pixel art, and he just completed one of Luigi, nine months after a Mario effort that took 98 minutes start to finish.
While he adjusts the gameplay settings to keep the feat from being impossible, there's no doubt this is a work based on being served pieces at random and then figuring out how to place them or clear them off in order to deliver the final image.
This one took 65 minutes. (Don't worry, that video is sped up.) Watch the construction of Luigi's head. It takes forever. The creator, YouTube user Shuey187, is nothing less than a Tetris savant.
Man uses Tetris to Create Luigi, Awe [Joystiq]