Background: Patients with sickle cell anemia (SCA) are prone to recurrent crises painful crises due to hypoxemia, which needs to be corrected prevent serious complication. Objectives: This study, aimed to determine the frequency of hypoxemia in patients with sickle cell anemia during the steady state and during crises, and to assess the difference in oxyhemoglobin saturation between those in steady state and those in crises Methodology: This is a prospective cross sectional hospital based study where 180 children with SCA y enrolled in this study. Oxygen saturation was measured for all children by pulse oximeter and full blood count was also done. Results: males were 112 and females were 68, in age group 6 month to 16 years, 120 of them were in sickle cell crises, while 60 in their steady state. Oxygen saturation was determined using pulse oximeter. The overall frequency of hypoxemia (Spo2< 90) was found to be 13.9% and the mean Spo2 was 93.68. The frequency of hypoxemia in pt with steady state was 10 while in those with crises was 15 and there was significant difference (P. value = 0.002. Significant in those with low weight centile (P. value =0.023) . Hypoxemia was found to be not correlated with patient’s Hb level (P. value = 0.684), also not significant in HCT level (P. value = 0.384). Hypoxemia was found to be associated with history of number of blood transfusion (P. value = 0.002). Conclusion: Hypoxemia was significantly higher among children with SCA during vaso-occlusion crises. We recommended that one should have a high index of suspicion and take prompt action in managing these individuals.