Abstract Objective To compare oxygen cost (mL·kg−1·m−1) and cardiovascular response (beats/m) and oxygen consumption (mL·kg−1·min−1) and heart rate (beats/min) to stair ascending and descending with walkers, with canes, and without assistive devices (ADs) in older adults. Design Descriptive, repeated measures. Setting Indoor stairway. Participants Convenience sample of able-bodied volunteers, non-AD users (N=14; mean age, 63.71±11.7y; mean body mass, 72.7±14.1kg; mean height, 165.7±9.2cm). Interventions Participants performed 4 randomized trials of stair ascending and descending at their own self-selected speed with 3 ADs: single-point cane, standard walker (SW), and wheeled walker (WW). They also performed unassisted stair ascending and descending. Each trial consisted of a 5-minute steady-state session followed by a 2-minute data collection period. Steady-state expired ventilations were collected in Douglas bags for metabolic analysis. Main Outcome Measures Oxygen cost (mL·kg−1·m−1), heart rate (HR) response (beats/m), oxygen consumption (mL·kg−1·min−1), and HR (beats/min) were compared for each trial of stair ascending and descending using analysis of variance repeated measures (P<.05). Results Greater oxygen cost (per meter) was found for stair ascending and descending using the single-point cane (121%), SW (217%), and WW (232%) compared with unassisted stair ascending and descending (P<.05). Increased HR response (per meter) was found for stair ascending and descending using the single-point cane (116%), SW (126%), and WW (147%) compared with unassisted stair ascending and descending (P<.05). However, oxygen consumption (per minute) and HR (per minute) were not significantly increased during stair ascending and descending with the ADs compared with unassisted stair ascending and descending. Participants stair ascended and descended at significantly (P<.05) reduced speeds during trials with the ADs. Conclusions This research should aid clinicians by providing evidence to base recommendations on regarding AD usage when encountering stairs during home and community ambulation.