Finding the balance in the treatment of anemia in SCD. The correction of anemia in SCD requires careful balancing of the detrimental effects of anemia with the potential risks associated with increased blood viscosity. Anemia is known to impair oxygen delivery, contribute to chronic ischemia and organ damage, and affect patients’ quality of life. On the other hand, there is limited evidence for whether raising hemoglobin levels through transfusion or drug therapy can lead to increased vaso-occlusive pain, reduced tissue perfusion, and viscosity-associated complications such as stroke. Additional work is needed to identify safe hemoglobin targets and balanced treatment approaches for managing anemia in SCD.