The erythrocyte sedimentation rate (ESR) is a nonspecific screening test to assess elevations of acute phase proteins that occur in various acute and chronic diseases. The aim of the study was to compare the ESR values by automated analyzer against the standard Westergren’s method. The comparison was done among 450 patient’s samples. In which 90 samples showed high degree of difference because of high ESR values and 180 samples showed low degree of difference because of low ESR values. The conclusion was automated ESR estimation helped a lot in measurement of ESR values in short time, but marked difference of ESR values shown in high ESR values.