An ankle-brachial index (ABI) is determined by comparing blood pressures of the extremities. No study that compared the blood pressure measurements obtained by standard or vascular cuffs was found. This study investigated the reliability of ABI measures using standard and vascular pressure cuffs. Two raters measured 480 systolic blood pressures of 10 healthy participants using standard and vascular cuffs. Intrarater reliability for standard cuffs was weak (intraclass correlation coefficient [ICC] = 0.42–0.63) and moderate to strong for vascular cuffs (ICC = 0.70–0.87). Interrater reliability was moderate to strong for both standard and vascular cuffs (ICC = 0.83–0.96). Reliability of ABI measures with vascular cuffs was moderate to strong. The results of this study suggest and recommend the vascular cuff for accurate measures to determine reliable ABI values. If a standard cuff is used, the blood pressure should be measured twice and averaged for the ABI calculation.