The period of adolescence in the patient with sickle cell disease seems to be a period of relative calm, medically speaking. The current 5-year prospective Cooperative Study of the Clinical Course of Sickle Cell Disease should demonstrate the actual spectrum of disease in this age group. The recent literature documents the significant relationship between retardation of growth and sexual maturation in the child with sickle cell disease, an effect which seems independent of the severity of the disease.Several other major problems in the adolescent are discussed, including psychological disturbances, leg ulcers, aseptic necrosis, pulmonary disease, priapism, stroke, cholelithiasis, and birth control. A retrospective series of 76 cases of sickle cell disease is briefly presented and the complications occurring during the second decade of life are reviewed.