Background: Sickle cell anemia (SCA) is a genetic hematological disorder characterized by red blood cells that assume abnormal, rigid, and sickle shape. The musculoskeletal complications of SCA result from vessel occlusion, leading to tissue ischemia and infarction and progressive end organ damage. Aim: The aim of this study was to determine the pattern of musculoskeletal complications among children with SCA admitted at the University of Nigeria Teaching Hospital (UNTH) Ituku Ozalla. Subjects and Methods: This is a retrospective study of cases of musculoskeletal complications among SCA patients admitted in UNTH over a 58 month period. Data were analyzed using the SPSS version 20 and GraphPad Prism 5 softâwares. Variables analyzed include musculoskeletal complications, age and gender distribution of subjects. Fisher’s exact was used to test for significant association of categorical variables while Mann Whitney Uâtest was used to compare the means. A P value of less than 0.05 was accepted as significant. Results: There were 300 registered patients in our sickle cell clinic. A total of 78 patients (52 males and 26 females) were admitted between January 2007 and October 2012. The median age of the patients was 10 years (range: 9 months to 17 years). 25 of the 78 patients had musculoskeletal complications, giving a prevalence rate of 32.1%. The most common musculoskeletal complication was acute osteomyelitis, diagnosed in 10/78 (12.8%) of the patients. Conclusion: Acute osteomyelitis is the most common musculoskeletal complications in children with SCA attending UNTH Ituku Ozalla.