Records of the Sickle Cell Clinics of the South Carolina Children's Rehabilitative Services from 1977 to 1990 were analyzed for cases of osteomyelitis. Cases included in the study demonstrated either positive bone cultures or blood cultures with correlating radiographs. Seven hundred seventeen charts were reviewed, and 16 cases of osteomyelitis were identified in 15 patients. Thirteen cases were due to Salmonella sp., one was due to Proteus mirabilis, one to Escherichia coli, and one to Staphylococcus aureus. The annual incidence of osteomyelitis in our series was 0.36%.