Alpha-tocopherol and bilirubin antioxidant properties were evaluated in sickle cell disease. The total peroxyl radical trapping antioxidant activity of plasma (TRAP) was measured with a polarographic method using hemin as oxidative stress initiator. The TRAP was not correlated with plasma alpha-tocopherol concentration. The TRAP was correlated with plasma total bilirubin concentration [TRAP = 8.1 (total bilirubin) +363.7 (r = 0.67)] and the correlation was even better with the sum (alpha-tocopherol + total bilirubin) plasma concentration [TRAP = 9.1(alpha-tocopherol + total bilirubin)+ 170.5(r = 0.77)]. The alpha-tocopherol contribution in the antioxidant capacity of plasma was significant but bilirubin level acted as the limiting factor of plasma antioxidant capacity in sickle cell anemia. This result can be explained by the antioxidant property of bilirubin but also by coantioxidant activity towards oxidized alpha-tocopherol.