I do DOT physicals and some people I need a larger cuff. I had one similar, but misplaced it during a move. So I ordered this one. It was new, good packing, seems well made and great price. It states it is for the thigh, but can also be used on larger arms. I haven't had to use it yet, and I hope that the bulb is easier to pump than my last one. Either way, I needed it for work. thanks