A sphygmomanometer simulator for live training includes an upper arm cuff for a simulated patient; a rigid walled pressure vessel within the cuff; a manual inflator and manual release valve coupled to the rigid walled vessel to selectively increase and release the pressure within the pressure vessel; a pressure sensor coupled to the pressure vessel; a cuff controller receiving the pressure sensor measurements and controlling a speaker within the cuff to emit designated simulated Korotkoff sounds associated with a simulated blood pressure and with the pressure of the pressure vessel; a visual gauge controlled by the cuff controller and displaying a pressure associated with the pressure in the pressure vessel and simulated Korotkoff gauge bumps associated with the simulated blood pressure for the simulated patient; and a user controller coupled to the cuff controller for inputting the simulated blood pressure for the simulated patient.