The erythrocyte sedimentation rate (ESR) is an easy and common routine laboratory technique. Over the last few decades, new methods have been proposed to reduce biological sample manipulation, to measure rates using an automated system, to optimize the workflow and to reduce blood volume from venipuncture. The aim of this study was to compare the efficacy of the Microtest X technique with the original Westergren method. EDTA blood samples of 25 subjects were submitted to both methodologies. A positive correlation (p<0.0001; R2=0.809) was found as was agreement with Bland-Altman analysis. In conclusion, the Microtest X technique allows precise and accurate measurements of ESR and can be used to replace the Westergren method. The benefits of Microtest X are the use of very small volumes of EDTA samples, it reduces sample manipulation avoiding occupational hazards and markedly reduces the analytical time.