A focus on the available pharmacotherapy for sickle cell disease and the new treatments that has been discovered and their mechanism of action.As well as future improvements and potential clinical trail. Progress in hematopoietic stem cell transplant and gene theraphy might also give more chances for cures in the near future. New therapeutic agents have aimed at cell division , inflammatory pathways, hemoglobin F up regulation, hemoglobin polymerization and sickling , coagulation and platelet activation.