A method of estimating the fatigue strength and finite fatigue lives of components subjected to pulsating internal pressure is presented. An empirical expression describing the effect of the pressurization medium in contact with the bore surface is used, to correlate the fatigue strength of thick-walled cylinders subjected to pulsating internal pressure with the uniaxial fatigue strength of the cylinder material. This work is extended to examine the influence of high mean pressures. A fracture mechanics crack propagation law is used to estimate the finite fatigue lives of the cylinders. Estimated fatigue curves show good agreement with experimental results. Finally, design curves are presented from which fatigue limit and finite fatigue lives may be readily estimated.