Background: Pregnancy in women with sickle cell anemia is associated with adverse outcome for mother and child, but with improvements in medical care, the outcome has greatly improved in developed countries. Despite being the most prevalent genetic disease in Africa, sickle‑cell disease, along with its serious health problems in pregnancy, is largely neglected. Objective: To determine the effects of preconceptual care on pregnancy outcome among booked patients with homozygous sickle cell disease at Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: A cohort study of the pregnancy outcome, among booked 39 pregnant women with homozygous sickle cell disease (Hbss), who had preconception care, and an equal number of booked pregnant women with homozygous sickle cell disease (Hbss), who did not have preconception care (controls), at Aminu Kano Teaching Hospital, between January 2000 and December 2006. Results: There was no statistically significant difference in the occurrence of complications between the two groups, but complications occurred with less frequency among the cases compared to the controls. Conclusion: This study suggest that preconception care and effective prenatal care by a multidisciplinary team, and delivery in a hospital which is accustomed to management of sickle cell disease and its complications, is associated with good pregnancy outcome in women with sickle cell anemia in pregnancy.