Bone marrow transplantation has curative potential for patients who have sickle cell disease. However, concerns about short-term and long-term toxicity, lack of suitable stem cell donors, and limited access to this treatment currently make it an infrequently utilized treatment for sickle cell disease. The current results of bone marrow transplantation for sickle cell disease and barriers to wider application are reviewed. Strategies that might lead to broader availability and reduced toxicity of bone marrow transplantation are discussed.