This small soft-back volume has been written by three authors closely associated with the Comprehensive Sickle Cell Center at Duke University, North Carolina. It is clearly laid out with seven chapters addressing the Pathophysiology of Sickle Cell Disease, Clinical Manifestations, Modes of Transfusion, Indications for Transfusion, Controversies, Immunologic, and non-Immunologic Complications. It presents a useful review targeted for non-experts in the disease and is written in an informal style which can best be portrayed as reader-friendly. Occasional lapses suggest that the authors are not intimately associated with all recent developments as illustrated by the reference on page 1 to the sickle cell gene occurring in ‘parts of southern India’. This seems to refer to the initial description of the gene among primitive tribes in the Nilgiri Hills by Professor Hermann Lehmann in 1952. Over the last 30 years the Anthropological Survey of India and other groups have conducted extensive population surveys indicating the gene to be frequent throughout central India (Orissa, Madhya Pradesh, and Maharastra). Some estimates suggest an average sickle cell trait frequency of 15%, which, bearing in mind the numerator of 300 million, may imply that there are more cases of the disease born in India than in Africa! In chapter 2, on clinical manifestations, there is a potential source of confusion under the phenotypic heading of ‘Hemoglobin S with high fetal hemoglobin’ when it is unclear whether they refer to SS disease with high levels of HbF or the benign syndrome of sickle cell–hereditary persistence of fetal haemoglobin. The authors may wish to revise the table of haematological values in which the mean haemoglobin of Sβ+ thalassaemia is stated as 9.3 g/dl, probably 3 g too low for the −29 and −88 mutations which cause most of the Sβ+ thalassaemia in black populations. Chapter 3 presents clearly the methods and options for transfusion. Chapters 4 and 5 could have been presented together, since the first deals with generally accepted indications and the second with controversial indications. Which chapter the topic falls within will be determined by the perceived risk/benefit ratio of the physician. Generally however, this balance is well maintained and the available data presented objectively, stressing the need for more evidence, and giving clear recommendations when justified. The last two chapters deal with complications, chapter 6 providing a useful review of immunological complications, predominantly red cell alloimmunization, transfusion reactions, and approaches to the prevention of alloimmunization. The last chapter on nonimmunological complications focuses on iron accumulation and transfusion-acquired infections. A surprising omission is the problem of maintaining venous access in patients on chronic transfusion programmes where implantable ports may carry considerable risks of infection and thrombosis. With these minor reservations, this volume provides a balanced summary on the role of transfusion in the management of sickle cell disease, especially for non-experts with small numbers of patients.