The erythrocyte sedimentation rate (ESR), or sedimentation rate (sed rate), is a measure of the settling of red blood cells in a tube of blood during one hour. The rate is an indication of inflammation and increases in many diseases. Westergreen method is routinely used determination of ESR, however, it requires large volume of blood and it is time consuming as it takes one hour for analysis. In order to overcome these challenges, new technologies have implemented an automated system which saves on labour, no need for aliquots, shorter turnaround time and minimizes exposures of laboratory staff to biohazard risks. The main objective of this study was to compare Westergreen method and automated IRIA analyzer in determination of ESR. The specific objectives were to determine the ESR using both Westergreen tube method and automated IRIA analyzer and to determine the correlation between Westergreen tube method and automated IRIA analyzer methods. This cross-sectional study was carried out in 205 blood samples at Polyclinique La Medicale from August 2017 to April 2018. Data were analyzed using SPSS, version 21. The current study included a total of 205 participants 123 (60%) females and 82 (40%) males. For a total of 205 participants, the normal tests on westergren method were 142 (69.3%) and abnormal tests were 63 (30.7%), whereas for automated IRIA ESR analyzer, 131 (63.9%) were normal and 74 (36.1%) tested abnormal. There was a strong correlation between automated IRIA ESR analyzer and Westergreen method with r=0.9. The authors recommend that IRIA ESR analyzer should be used in determining ESR due to its advantages over Westergreen method.