BACKGROUND Medical compression stockings (MCSs) can be divided into different classes based on ankle pressure. OBJECTIVE To determine whether, in clinical practice, off-the-shelf round knitted moderate MCSs exert the intended ankle pressure (23-32 mmHg, recommended by the European Committee for Standardization), whether repeated donning and doffing influences pressure, and whether the pressure gradient descends in a distal-to-proximal direction. PATIENTS AND METHODS In an open study of 50 patients, resting pressure exerted at the ankle and at four defined measurement points along the medial aspect of the lower leg by round knitted moderate MCSs was measured in clinical practice. RESULTS The mean ankle interface pressure was 25.84 +/- 5.7 mmHg (range 11-37 mmHg). In 32% of MCSs, it was outside of the desired range. In 75% of these cases, the figure was below and in 25% above the desired range. Repeated donning and doffing caused no significant change. A continuous distal-to-proximal descending pressure gradient was found in 66% of MCSs. CONCLUSIONS Resting pressure exerted on the lower leg by this MCS was in line with the expected ankle interface pressure and the distal-to-proximal pressure gradient along the lower leg in 62% of cases. The authors have indicated no significant interest with commercial supporters.