OBJECTIVES:  Among the genetic-based anemias, sickle cell disease (SCD) is a major cause of morbidity and mortality. In addition to anemia, patients present with, vaso-occlusive crisis (VOC), a prevalent painful complication of SCD in adolescents and adults. Limited information is available to understand causes and types of readmissions for patients with SCD VOC to determine the quality and efficiency of SCD care, the potential budget impact and the need for improvement. The objective is to understand the frequency and charges of readmission among SCD patients discharged following a VOC. METHODS:  Using Medicare data, we calculated readmission rates among patients with a primary diagnosis of unspecified VOC (International Classification of Diseases, 9th Revision, Clinical Modification diagnosis code 282.62, 282.64, 282.69, 282.42). Readmission was defined an all-cause hospital admission or VOC admission within 3, 7, 15 and 30 days after the index admission. RESULTS:  There were 1, 753 institutions (individual and organization health care providers) with VOC related discharges from January to December 2013. The average all cause readmission rate for this institution was 42% and for VOC readmissions was 36%. Within these institutions there were 23,753 VOC related patient discharges from January to December. Of these discharges, 4,412, did not have a readmission, 8,179 discharges had an all cause readmission and 6,995 had a VOC specific readmission within 30 days. A total of 19,678 discharges from January to October in an inpatient setting resulted in 33% returning to an ER visit within 30 days. Of these discharges the average charges ranged from $1,589.54 to $2,036,824.40. CONCLUSIONS:  Our findings suggest there is a high readmission rate of adult patients with SCD/VOC. It indicates the need for improvement in the management of pain during hospitalization and at home post discharge.