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Background Puberty is reported to be impaired in children with Sickle Cell Anemia (SCA). We therefore, aimed to explore clinical and hormonal features of puberty in Cameroonian children with emphasis on the factors associated with delayed puberty during SCA.Methods During a case-control study, we included 64 children aged 8 to 18 years with SCA matched to healthy controls. We assessed height, weight, body mass index, body composition and Tanner stages. Hormonal measurements included Follicle Stimulating Hormone, Luteinizing Hormone and sex steroids (estrogens/ testosterone) with radio-immunologic assays. We used a non-parametric test (Mann U Whitney Wilcoxon) to compare the median values ​​between cases and controls. We looked into associations between severity criteria of SCA and delayed puberty through multivariate analysis.Results Delayed puberty was reported in 27.3% of girls and 10% of boys with SCA. Median age of menarche was delayed by 2 years compared to controls. SCA patients had low free fat mass compared to controls (p = 0.03). Abnormal levels of Antimullerian hormone were reported in cases. History of severe infection, acute chest syndrome as well as low hemoglobin level were associated with delayed sexual maturation in children with SCA.Conclusion Our study reveals delayed puberty in children with SCA. Moreover, puberty is affected by severity of the disease. This highlights importance of regular monitoring of puberty during follow-up of these children.