Background: Sickle cell disease (SCD) remains one of the most prevalent genetic disorders in Sub Saharan Africa. Beyond the well-documented hematological and infectious complications, the concept of a “sickle cell facies” has been long discussed by clinicians. However, this clinical impression has rarely been substantiated by scientific studies, particularly in the Congolese context.

Aim: This research aimed to determine whether measurable differences in growth and facial morphology could distinguish homozygous sickle cell children (HbSS) from their healthy peers (AA).

Methodology: We conducted a case-control study in Lubumbashi and Kinshasa, involving 85 children with confirmed homozygous sickle cell disease (HbSS) and 425 healthy AA controls, aged 6–13 years. Data collected included height, weight, head circumference, and various craniofacial measurements (nose, face, ears). Measurements were taken using standardized photo-anthropometry and analyzed statistically by comparing means, with a significance threshold set at p<0.05.

Results: Children with sickle cell disease presented with growth retardation from an early age. Their head circumference was smaller than that of the controls until age 8, after which this difference diminished. Morphologically, they had a wider and higher nose, with a significantly increased nasal index. Their faces were generally taller and wider, and their ears were also larger in height and width compared to the healthy children.

Conclusion: This study highlights the existence of a distinct morphological profile in Congolese children with sickle cell disease, confirming the clinical intuition of a “sickle cell facies.” These characteristics could, in the long term, enrich diagnostic tools and guide screening in settings where access to biological exams remains limited.