This study aimed to investigate the pressure distribution beneath the denture bases of removable partial dentures (RPDs) with different occlusal rest designs (ORDs) by in vivo measurement. Four types of detachable occlusal rests (mesial and distal, distal, mesial, and nonrest) were placed on the direct abutment teeth of distal extension RPDs in four patients with free-end edentulous mandibles. Pressure measurements were obtained by using thin and flexible tactile sensors. The results showed significant variances with different ORDs in all four patients (P .05), leading to the conclusion that the pressure distribution on the residual ridge beneath the RPD base was dependent on the ORD.