Children with sickle cell disease (SCD) are repeatedly exposed to diagnostic radiation. We identified 938 children with SCD who had 9,246 radiographic tests. Mean number of tests/patient was 9.9 (95% CI: 8.9–10.9) over 8,817 patient-years. Mean rate was 1.5 tests/year (95% CI: 1.3–1.6). On average, a child with SCD will have 26.7 (95% CI: 24.1–29.3) radiographic tests by 18 years of age, and 5% will have ≥100 tests. Six percent have ≥3 CT scans, which may be associated with an increased risk of cancer. Strong consideration should be given to limiting the exposure of children with SCD to radiation.