The design of a noninvasive reflectance pulse oximeter that uses the same principle of transmittance pulse oximeter and analyses the oxygen saturation of arterial blood was described. Four sets of red and infra-red LEDs were used as light sources. The respective reflectance photoelectric outputs were used to make an internal calibration curve of the instrument relative to the arterial oxygen saturation values measured with a Co-Oximeter (OSM-3) in five healthy nonsmoking subjects during steady-state hypoxaemia. The accuracy of the present instrument was studied in six patients with respiratory failure. From 22 samples, a good correlation coefficient (0.98) with a standard deviation of 1.42 was obtained in the range between 73 and 100 per cent between the arterial oxygen saturation measured with the present instrument and that with the Co-Oximeter. The result strongly suggests the usefulness of this oximeter in monitoring patients with hypoxaemia.