All depends on your waist and where you lie between a 6 pack and a keg 😅 a medium works length wise just as long as you can fit your waist in it which shouldn't be an issue unless you're more of a keg belly lol The PP90 has a pretty generous cut, also I've noticed a medium PP90 isn't always the same as another medium PP90... I just got a new Kings PP90 and it's longer than my other PP90's, it's not marked as a longer model but it feels bigger than the others, so I guess depending when and where they were made there could be slight differences (and maybe that's why some end up at PSH and on the second hand market).