Sickle cell anemia (SCA) is associated with signicant complications such as priapism and erectile dysfunction (ED), which affect 30-45% and 25-80% of males with SCA, respectively. These complications are primarily ischemic, stemming from vaso-occlusive episodes that hinder blood ow, leading to painful, prolonged erections and potential tissue damage. This review discusses the pathophysiology behind these issues, highlighting the obstruction of venous outow by sickled cells in the corpora cavernosa. It differentiates between ischemic and non-ischemic priapism, noting the former's prevalence in SCA. The review emphasizes the importance of prompt clinical evaluation and management to prevent long-term damage and enhance quality of life for affected individuals.