Brand new in box, never opened. Comes with hand pump. I ended up with two, so selling a second one as I don't need two (the last picture is of the second one I use and have open for reference). I love the one I have it was great for pregnancy (life saver during labor, if was good to bounce during contractions!) and beyond and the cream color works great in my home decor. From manufacturer: Excellent stability ball for yoga, pilates, physical therapy or even bouncing your baby to sleep. It can even help improve posture and core strength when used as an exercise ball chair, making it great for the office or working from home.