Background and Aim: It is well known that hydroxyurea impacts hematologic indices in sickle cell disease (SCD), we aimed to evaluate the effect of hydroxyureahematological improvement in children with sickle cell anemia in our Indian based setup.Methods and Materials: Its an ambiperspective observational study which was conducted at our tertiary care center for a duration of 1 year and 8 months. After recording complete history190 patients were enrolled and started on Hydroxyurea and followed up every 2 months till 1 year, at every follow up, total Hb, HbF levels, MCV, MCH were compared before and after treatment with Hydroxyurea for one year. Results: Of 190 total recruited patients, 84 were studied at the end because of loss to follow-up due to various reasons. Significant increase in haemoglobin, RBC indices(MCV and MCH) and HbF were noted (p<0.05).Conclusion: The use of hydroxyurea in our native population increasestotal Hb, HbF levels, MCV andMCH before and after treatment with Hydroxyurea for one year in sickle cell patients.