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Abstract: Nicosan is an anti-sickling, phyto-pharmaceutical drug developed by Nigerian scientist for the prophylactic management of sickle cell disease. The aim of this study was to evaluate the role of nicosan in children with sickle cell disease in Port Harcourt, Nigeria. Medical case notes of the children were reviewed from 1st June to 31st May 2011. Information obtained included haemoglobin genotype, age and gender. Also, past medical history of crisis, stable state packed cell volume, type of crisis and admissions before and after commencement of nicosan therapy were reviewed. Data was analysed using SPSS Version 15. Discrete and continuous variables were compared using chi-square (χ2) and Student t-test, respectively. The p<0.05 was statistically significant. There were 115 sickle cell patients. About 82 were males while 53 were females. The mean age of the patients was 6.7±4.1 years. The packed cell volume before and after commencement of therapy was 21.1±3.3 and 22.9±2.5, respectively (p≥0.05). Vaso-occlussive crisis was the commonest crisis (82.6%). Most 83 (72.2%) had >3 episodes of bone pains before commencement of nicosan while 41 (35.7%) had >3 episodes after commencement of therapy (p≤0.05). A total of 47 (40.2%) of the 115 patients with SCA were admitted (range 1-5 admissions) in the facility during the preceding year but with the commencement of nicosan therapy only 13 (11.3%) were admitted (range 1-3 admissions). Nicosan is useful in the prophylactic management of sickle cell disease in Nigeria.