Bone mineral density (BMD) was evaluated in the proximal femora (femoral neck, Ward's triangle, and greater trochanter) and lumbar spines of 25 black children and young adults with sickle cell anemia using dual-photon absorptiometry. Compared with normal subjects from the general population, the patients with sickle cell anemia exhibited lower bone mineral density values in all scan regions (approximately 6% to 21% lower than expected). These differences in the lumbar spine were significant for both girls and boys. When compared with normal black subjects from the general population, the girls with sickle cell anemia exhibited significantly lower lumbar spine bone mineral density, and the boys with sickle cell anemia exhibited significantly lower bone mineral density in the femoral neck and Ward's triangle. No consistent or significant correlations were found between the bone mineral density data and the patients' hematologic indices.