Epidemiological and Hematological characteristics of a cohort of children with sickle cell anemia attending a specialist out-patient clinic in a rural hospital? To study the pattern, type and frequency of crises/ infections in sickle cell anemia children.To observe the effect of intervention (penicillin prophylaxis, folic acid, regular follow up) on the pattern of crisis and infections in disease. To study the hematological values in sickle cell anemia children at recruitment. To correlate hemoglobin and hematocrit values to number of crisis/ infections in disease.To study the effect of intervention on academic performance in disease. A prospective study on 131 children revealed that 44.27% were of disease and 55.73% were traits. Most patients, in both disease and trait, belonged to the age group of 4-8 years comprising 47.32% of total patients. Patients of lower socio-economic status constitute the most common class in both in disease (67.24%) and trait patients (65.75%). Recurrent fever (51.14%) was the most common symptom in both group, Splenomegaly (44.27%) was the most common sign. Patients with sickle cell disease presented most commonly with vaso-occlusive crisis (51.72%) of which hand-foot syndrome was most common (20.69%). Hemoglobin less than 5gm% and age group 0-4yr is associated with highest number of crisis or infection but there is statistically significant decrease in episodes of crisis/infection following penicillin prophylaxis.