I'm 5ft 6" tall and my waist ranges from 34" on the narrow side to 38" as I gain extra pounds (I ranged from 190lbs to about start 165 now). The medium size has worked great for my weight fluctuations. I've been wearing this belt almost every day for over 3 years and it holds up great. High quality leather, pleasant to the touch. Maybe not as good as expensive belts, but better than anything you'll find at WalMart or other options in this price range. Does not come with a buckle so make sure you know this before purchasing this item. The description clearly states that the buckle is not included. and I knew that, but I want to make sure my review makes it clear if anyone didn't get it. I already have a couple of buckles that I love and my old belt just broke after 3 years so this option is great without me, the buckle has arrived. This belt outlasted my last belt, which cost twice as much as this one. Will definitely buy it again when it finally breaks. Great product, great material, great price.