Sickle cell disease (SCD) is a chronic, challenging global health problem. In Iraq it is highly prevalent in two Governorates: Basra in the extreme south and Dohuk in the extreme east-north. In Basra, it represents a big burden to patients, their families and the health care system. Lot of genetic (like ¿-chain haplotypes, hemoglobin (Hb) F concentration and the ¿-thalassemia co-inheritance) and environmental factors contribute in affecting the disease behaviour.