Objectives: Sickle Cell Disease is a disabling disease which causes Symptomatic Avascular Necrosis (AVN) of the Femur Head, causes multiple visits along with prolonged stay in hospital and finally complete damage of the major weight bearing joint of the body: The Hip Joint. Properly early diagnosis and treatment can improve quality of life. Apart from vaso -occulsion and osteonecrosis, which occurs secondary to sickling, predisposing to infection. The disease also attacks the humerus head which in its final stage causes collapse of the head and arthritis of the joint. Thus it requires careful monitoring by imaging, and timely intervention by surgical or non-surgical methods. Aim of this article is to go through the different imaging techniques and to clarify whether AVN predicts acute care utilization in adults with Sickle Cell Disease and to identify characteristics that predict higher utilization in those with AVN. Methodology: We reviewed medical records of 37 symptomatic AVN patients of SCD and compared acute care utilization and clinical characteristics with 37 sex- and age-matched patients without symptomatic AVN of SCD. Patients with ≥2 years of follow-up were included. Outcomes were compared using multivariate regression. Results: our study included 564 follow-up years, with a median of 2 years per patient. The group with AVN had greater median rates of urgent care visits (3.6/year vs 1.6/year; P = 0.0095), admissions (1.5/year vs 0.6/year; P = 0.0042), and admission days (6.1 days/year vs 2.8 days/year; P = 0.0057). History of acute chest syndrome (Odds Ratio 3.72; P = 0.025), pneumonia (Odds Ratio 2.20; P = 0.003), hydroxyurea therapy (Odds Ratio 2.63; P = 0.046), and long-term transfusion (Odds Ratio3.33; P = 0.064) were associated with AVN. In a median regression model, pneumonia, acute chest syndrome, and AVN were independently associated with greater urgent care visits and admissions. Conclusions: In patients with sickle cell disease, Symptomatic AVN was found to be a risk factor for acute care utilization. As it is a potentially modifiable factor, further studies are needed to determine whether Avascular necrosis prevention/early treatment interventions will improve outcomes for patients with Sickle Cell Disease.