genetic abnormalities in which there is inheritance of Hb S (sickle hemoglobin) from both parents, or Hb S from one parent and a gene for beta-thalassemia or an abnormal hemoglobin from the other parent. The most common and the most severe form is sickle cell anemia. Aim of Study: To evaluate the feasibility of MRI in early detection of musculoskeletal complications of pediatric sickle cell disease (SCD) aiming to discriminate osteomyelitis from infarction. Patients and Methods: This prospective study included 30 patients (21 boys, 9 girls) with a mean age of 5 years proved to have SCD and suspected to have osteomyelitis. All patients underwent X-ray and different sequences MRI. Results: Persistence of red marrow and multiple bone infarctions were the most common MRI findings followed by osteomyelitis in 8, chondritis in 7, myositis in 4, septic arthritis in 3, subperiosteal and soft tissue abscess each in 2. There was difficulty in discriminating infarction from osteomyelitis Conclusion: MRI is helpful in early identification of musculoskeletal abnormalities in SCD in pediatrics. Early detection is crucial to initiate treatment to avoid the complication.