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Objective To ascertain the impact of definition and diagnostic criteria on sural sparing in Guillain–Barré syndrome (GBS). Methods We retrospectively reviewed records of 78 consecutive patients with GBS from Birmingham, UK (2001–2012) studied within 21 days post-onset. Different criteria were initially used for subtype classification. Sural sparing was subsequently ascertained using historical/recent definitions. Results With Hadden et al.’s criteria, “absent median present sural” and “absent median normal sural” patterns offered sensitivities of 21.7% and 15.2% respectively for AIDP, with specificities of 100% versus axonal GBS. Present sural with two abnormal upper limb responses had a sensitivity of 19.1% and 100% specificity. “Abnormal radial present sural” and “abnormal radial normal sural” patterns had sensitivities of 18.9% and 16.2% and specificity of 100%. With newly-proposed criteria ( Rajabally et al., 2015 ), “absent median present sural” and “absent median normal sural” patterns offered sensitivities of 27.8% and 19.4% respectively, with specificity of 100%. Ulnar patterns were unhelpful with both criteria. Other patterns had suboptimal specificity. Conclusion Although of low sensitivity, sural sparing defined by absent median/present sural patterns, is specific of AIDP versus axonal GBS, irrespective of criteria. Significance Sural sparing is definition and criteria-dependent in GBS but is specific of AIDP with historical definitions, regardless of criteria. [ABSTRACT FROM AUTHOR]