Although psychosocial concerns of patients with sickle cell disease have been described, these descriptions are based primarily on experience with adolescents and children. In addition, there is an absence of reports on sickle cell groups specifically designed for adult patients. This article reports on the development of an adult sickle cell support group and provides a description of the psychosocial factors most prevalent in patients' lives. Major adjustment difficulties for group members included increasing anxiety about death, the disruption of their social support network, disability, dependence on pain medication, and conflicts with health care providers. This community-based support group enhanced participants' knowledge about sickle cell disease, improved the physician-patient relationship, and helped resolve psychosocial adjustment problems.