Dissertation (MMED Pediatric and Child Health)Patients with sickle cell disease (SCD) are prone to iron profile derangements. This study aimed to determine the prevalence of iron deficiency and iron overload and their predictors among children aged between 6 months and 18 years at both St. Gemma Hospital (SGH) and Dodoma Regional Referral Hospital (DRRH) in Dodoma city. This was a cross-sectional analytical hospital-based study which included 174 patients with SCD attending SCD clinics at SGH and DRRH in Dodoma city from October 2020 to March 2021.Statistical analysis was done using SPSS version 20.0. Binary logistic regression was used to determine the predictors of both iron deficiency and iron overload. P-value less than 5% was considered significant. The prevalence of iron deficiency and iron overload in this study was 28 (16.1%) and9 (5.2%), respectively. Family income of less than 70, 000/= Tshs/month (AOR=2.2, 95% CI=1.073-2.490, p=0.023), transfused with bloodless than 3 times (AOR = 5.45, 95% CI = 1.029-8.905, p = 0.046), and eating red meat per month (AOR = 3.60, 95% CI = 1.366-9.462, p = 0.010) were the predictors of iron deficiency. Moreover, being transfused with blood 3 times and above 3 months prior to enrollment into the study (AOR = 7.917, 95% CI = 1.256-9.888, p = 0.028) was the predicting factor of iron overload. The prevalence of iron deficiency and that of overload both indicate that, patients with SCD were at a high risk of getting deficiency of iron and at the same time a number of them might be affected with iron overload due to repeated episodes of blood transfusion. Although blood transfusion is a lifesaving process, measures should always be taken to prevent patients with SCD from ending with iron overload.