Abstract Objective Neurocognitive deficits associated with sickle cell disease (SCD) have been well established in the pediatric population but studies examining the adult neurocognitive profile are lacking. This study examined the utility of the Montreal Cognitive Assessment (MoCA) to screen patients for cognitive impairments within a multidisciplinary adult sickle cell clinic. Method Patients who presented to their scheduled appointment at the UCSF Benioff Children’s Hospital Oakland Adult Sickle Cell Clinic were provided psychoeducation and offered neurocognitive screening. Those that accepted completed a brief clinical interview and were screened with the MoCA by neuropsychology externs or a licensed clinical psychologist. Results A sample of 24 patients (M age = 37.63, age range = 18–75; female =58.33%) were screened with the MoCA. Of patients screened, 41.67% (n = 10) were identified as mildly impaired (M score = 22) and 16.67% (n = 4) were identified as moderately impaired (M score = 15.5), consistent with other studies in the literature. Overall MoCA score and the memory subdomain were both negatively correlated with increasing age (r = −0.15, p < 0.05 and r = −0.06, p < 0.05 respectively). Conclusions Utilizing the MoCA, our study demonstrates a notable prevalence of cognitive impairment identified in 58.43% of adult SCD patients, with a marked decline associated with advancing age. These findings suggest the MoCA’s utility; however, further research is needed to understand the validity of this measure in detecting the varying levels of cognitive impairment in adult SCD patients. Such measures could significantly enhance the care and quality of life for individuals with SCD and address age disparities in SCD, where resources for adult patients are much more limited.