Ves-Matic Cube 200 is fully automated analyzer that performs erythrocyte sedimentation rate (ESR) measurement using the standard ethylenediaminetetraacetic acid blood sample tube, thus markedly reducing the analytical time and avoiding the need for an extra blood sample. The aim of this study was to assess the automatic Ves-Matic Cube 200 system for the measurement of ESR in comparison with the original International Council for Standardization in Hematology reference method (Westergren). The evaluation comprised accuracy which was established using a 95% confidence interval (CI) for the mean difference between Ves-Matic Cube 200 and Westergren method (mean of difference: 0.47 ± 6.84 mm/h; 95% CI: −0.376 to 1.325 mm/h), within-run imprecision for samples with ESR values of 9, 42 and 95 mm/h (coefficients of variation: 9.19%, 13.88% and 5.66%, respectively) and method comparison (ρ = 0.95; Passing-Bablok regression equation: Y = −0.0435 + 1.0435 X; bias: −0.5; limits of agreement: −13.9 to 12.9). Stability was estimated after 24 h storage either at 4 °C and room temperature (mean of differences: −1.91 mm/h; 95% CI: −4.852 to 1.037 mm/h and mean of differences: −12.48 mm/h; 95% CI: −16.580 to −8.390 mm/h, respectively). The obtained results suggest that the Ves-Matic Cube 200 automated analyzer is reliable system for the measurement of ESR in clinical laboratories.