Objective. We conducted a needs assessment for patients with sickle cell disease (SCD) in South Carolina using statewide administrative data to examine acute care utilization during a defined 12-month period. The data were collected to provide information for state and regional service providers, managed care companies, and policy makers to identify demographic gaps in care and inform policy and educational efforts to improve care. Methods. We obtained records on emergency department visits and hospitalizations through patient-based uniform billing data. We stratified analyses of acute care utilization and 30-day readmission rates by patient age, region, and expected payer. Results. Young adults, those with public insurance, and those who resided in a region with the largest number of patients had the highest rates of acute care utilization and 30-day readmissions. Patients who resided in a largely rural area without access to comprehensive care also had high rates of acute care utilization and readmissions. The pattern of readmissions data suggested that data on 7- or 14-day readmission rates, in addition to data on 30-day readmission rates, could be used as benchmarks of quality of care for adult patients with SCD. Conclusion. Administrative datasets can provide important information on demographic gaps in care for patients with SCD. The results highlight both national and regional issues in the provision of health-care services for patients with SCD.