How are deques in Python implemented, and when are they worse than lists?

Check out collections.deque. From the docs:

Deques support thread-safe, memory efficient appends and pops from either side of the deque with approximately the same O(1) performance in either direction.

Though list objects support similar operations, they are optimized for fast fixed-length operations and incur O(n) memory movement costs for pop(0) and insert(0, v) operations which change both the size and position of the underlying data representation.

Just as it says, using pop(0) or insert(0, v) incur large penalties with list objects. You can't use slice/index operations on a deque, but you can use popleft/appendleft, which are operations deque is optimized for. Here is a simple benchmark to demonstrate this:

import time
from collections import deque

num = 100000

def append(c):
    for i in range(num):
        c.append(i)

def appendleft(c):
    if isinstance(c, deque):
        for i in range(num):
            c.appendleft(i)
    else:
        for i in range(num):
            c.insert(0, i)
def pop(c):
    for i in range(num):
        c.pop()

def popleft(c):
    if isinstance(c, deque):
        for i in range(num):
            c.popleft()
    else:
        for i in range(num):
            c.pop(0)

for container in [deque, list]:
    for operation in [append, appendleft, pop, popleft]:
        c = container(range(num))
        start = time.time()
        operation(c)
        elapsed = time.time() - start
        print "Completed %s/%s in %.2f seconds: %.1f ops/sec" % (container.__name__, operation.__name__, elapsed, num / elapsed)

Results on my machine:

Completed deque/append in 0.02 seconds: 5582877.2 ops/sec
Completed deque/appendleft in 0.02 seconds: 6406549.7 ops/sec
Completed deque/pop in 0.01 seconds: 7146417.7 ops/sec
Completed deque/popleft in 0.01 seconds: 7271174.0 ops/sec
Completed list/append in 0.01 seconds: 6761407.6 ops/sec
Completed list/appendleft in 16.55 seconds: 6042.7 ops/sec
Completed list/pop in 0.02 seconds: 4394057.9 ops/sec
Completed list/popleft in 3.23 seconds: 30983.3 ops/sec

https://github.com/python/cpython/blob/v3.8.1/Modules/_collectionsmodule.c

A dequeobject is composed of a doubly-linked list of block nodes.

So yes, a deque is a (doubly-)linked list as another answer suggests.

Elaborating: What this means is that Python lists are much better for random-access and fixed-length operations, including slicing, while deques are much more useful for pushing and popping things off the ends, with indexing (but not slicing, interestingly) being possible but slower than with lists.