I have a medium and 30 waist, I can cinch the harness up as far as it will go. That said I tried a couple sizes and the medium was more comfortable (more padding than the small). The comfort is outstanding with almost no pressure points. The sliding padding works well to keep your tie-in centered. Fabric is soft and feels good against bare skin. Gear loops are ok, not the best. They are covered in rubber and sometimes biners get caught on the rubber. They are a little far back for my tastes. It has 2 slots for ice clippers, but they are kind of far back as well. The waistbelt and leg loops never need to be doubled back which saves time when putting on the harness. The harness is on the heavy and bulky side.