The erythrocyte sedimentation rate (ESR) is the rate at which erythrocyte settles in a vertical column of anticoagulated blood in 60 minutes. It is a simple and inexpensive laboratory test that is frequently requested for, in clinical medicine. The ESR is a relatively non-specific test that is frequently requested for during the diagnosis and monitoring of disease. Although most clinicians know that anaemia is associated with a raised ESR, few take into account normal haemoglobin values when interpreting an ESR result. A total of 1000 cases were included. The Hb and ESR results were analyzed by using SSPS (version 20), p < 0.01 considered as significant level. Cases were categorized on the basis of hb level. The ESR should therefore be interpreted with due regard to the Hb. Category 1 (<6gm /dl) and category 5 (>16 gm/dl) showed inverse relationship between Hb and ESR. Patients under category 2,3 & 4 showed minor variations where probably the underlying cause was infection, age, pregnancy, smoking etc. Our study has demonstrated excellent correlation between haemoglobin and ESR which is comparable with all available literature.