Accurate measurement of blood pressure is dependent on a number of factors including use of the appropriate sized cuff. Overestimation of blood pressure by using an inappropriately small cuff has been well documented. The prevalence of the use of the standard adult and large adult cuffs in hypertensive patients is less well defined in the literature. Worldwide, the increasing prevalence of obesity and its associated conditions such as hypertension accentuates the importance of the recognition of the relationship of appropriate sized cuff and accurate blood pressure measurement. This is the largest study to define the prevalence of blood pressure cuff sizes in a hypertensive population. Vendors of blood pressure measurement devices should be aware of the changing demographics and the need for the large adult arm cuff to be routinely available.