This study investigated the erythrocyte sedimentation rate (ESR) in an elderly population with the objective of establishing reference ranges and the diagnostic value of the ESR. Elderly blacks were randomly selected from communities in the Orange Free State. ESR determinations were done according to the Westergren method. Total protein, albumin, immunoglobulin and C-reactive protein (CRP) levels were measured on serum. Results were analysed by means of non-parametric statistical methods. In the group with normal CRP' and immunoglobulin levels it was found that 99% of values were below 44 mm/h for men and 62 mm/h for women. The sensitivity and specificity for these cut-off values (CRP used as 'gold standard') were 33% and 91% respectively for men and 75% and 89% respectively for women.