The various blood pressure simulators have been proposed to evaluate and improve the performance of the automatic sphygmomanometer. These have some problems such as the deviation of the actual blood pressure waveform, limitation in the blood pressure condition of the simulator, or difficulty in displaying the blood flow. An improved simulator using disturbance observer is proposed to supplement the current problems of the blood pressure simulator. The proposed simulator has an artificial arm model capable of feeding appropriate fluids that can generate the blood pressure waveform to evaluate the automatic sphygmomanometer. A controller was designed and thereafter, simulation was performed to control the output signal with respect to the reference input in the fluid dynamic model using the proposed proportional control valve. To minimize the external fluctuation of pressure applied to the artificial arm, a disturbance observer was designed on the plant. A hybrid controller combined with a proportional controller and feed-forward controller was fabricated after applying a disturbance observer to the control plant. Comparison of the simulations between the conventional proportional controller and the proposed hybrid controller indicated that even though the former showed good control performance without disturbance, it was affected by the disturbance signal induced by the cuff. The latter exhibited an excellent performance under both situations.