Skull radiographs of 194 patients from 4 months to 55 years old with sickle cell anemia revealed porous decreased bone density in 25%, widening of diploe associated with a relative decrease in the width of the outer table in 22%, and vertical "hair-on-end" striations in 5%. The youngest patient with vertical striations was 5 years old and the oldest was 39. Serial examinations in 60 patients revealed no decrease of the skull width nor disappearance of the striations with age.