A new S-nitrosothiol (RSNO) detection strategy based on an electrochemical sensor is described for rapidly estimating levels of total RSNOs in blood and other biological samples. The sensor employs a cellulose dialysis membrane covalently modified with an organoselenium catalyst that converts RSNOs to NO at the distal tip of an amperometric NO sensor. The sensor is characterized by very low detection limits (<20 nM), good long-term stability, and can be employed for the rapid detection of total low-molecular-weight (LMW) RSNO levels in whole blood samples using a simple standard addition method. A strategy for detecting macromolecular RSNOs is also demonstrated via use of a transnitrosation reaction with added LMW thiols allowing the estimation of total RSNO levels in blood. The sensor is shown to exhibit high selectivity over nitrosamines and nitrite. Such RSNO detection is potentially useful to reveal correlation between blood RSNO levels and endothelial cell dysfunction, which often is associated with cardiovascular diseases.