Blood pressure (BP) forms an important constituent of the triumvirate of vital signs i.e. pulse BP and respiration. Measurement and treatment of blood pressure (BP) is one of the most common and important reasons for visiting a physician. The range of variance and level of reliability of the blood pressure (BP) measurements that should be used for clinical decision making and quality reporting are uncertain. The objective of this study was to compare the BP measurements and ascertain their range of variation between different tiers of healthcare workers. Comparative analysis of the BP measurements by Nursing staff Interns/Junior residents and Senior Resident/Consultant performed. We found that nursing staff recordings fit poorly compared to Jr. Residents /Interns and Sr. residents/Consultants showing high variance and low reliability. We concretely recommend to cross verifying the reliability and validity of the recordings made by the nursing staff by the clinicians themselves before clinical decision making and quality reporting. This study was performed at Department of Medicine Adesh Institute of Medical Sciences and Research Bathinda Punjab India. Keywords: Blood Pressure Measurements Expertise Tiers Decision