Approximately 700,000 new cases of sickle-cell anemia (SCA) occur annually in the world with 60%-80% dying before their 5 th year birthday. SCA patients often experience hospitalization events including admissions for pain and vaso-occlusive crisis, infections and blood transfusions. However, limited studies have evaluated these events to improve comprehensive care programs. A descriptive cross-sectional study design was adopted on 227 SCA patients receiving healthcare between January 2017 and December 2017 at Homabay County Referral Hospital, Western Kenya. A complete enumeration sampling technique was used, and data was collected from hospital medical records. A total of 167 (73.57%) SCA patients were admitted to the hospital, 64 (38.32%) had pain and vaso-occlusive crisis (PVC), 47 (28.14%) malaria infection and others had combination of infections or conditions. SCA patients with malaria had increased chance of admission (12.86% CI; 5.36-30.85%. P value <0.0001) and blood transfusions (11.67% CI; 5.27-25.82%, P value <0.0001). In addition, less than 20% were given drugs at the time of discharge suggesting unavailability of drugs. PVC is the leading cause of hospitalization and malaria infection prolong the period of admission and increases blood transfusions among SCA patients. The study provides important information on the need for improved care for PVC and enhanced malaria intervention among SCA patients.