This study aims to determine the pregnancy outcomes in women attending the combined obstetric sickle cell clinic at King's College Hospital, London from June 2000 to July 2006. There were 71 pregnancies in 65 women with sickle cell disease. Sickle crisis requiring admission occurred in 47% of the antenatal patients. The first admission occurred most frequently in the third trimester (23 vs 6 and 5 admissions in the second and first trimester; p < 0.001). There were no maternal deaths; other complications include anaemia requiring blood transfusion (32%), proteinuric hypertension (9%), infections (28%) and emergency caesarean section (30%). There was one fetal demise due to abruption. Pre-term delivery before 34 weeks occurred in 8% and 24% before 37 weeks. A total of 18% of infants had reduced growth velocity with the measurements crossing below the 10th centile.