Stroke is a major and common cause of morbidity and mortality in children who suffer from sickle cell anaemia (SCA). An elevated cerebral blood flow velocity measured by Transcranial Doppler (TCD) is a powerful predictor of stroke due to sickle cell anaemia. Cerebral blood flow velocity (CBFV) beyond 200 cm/sec in the middle cerebral or the terminal internal carotid arteries is associated with 40% risk of developing a stroke, and flow velocities of <170 cm/sec and 170–199 cm/sec are associated with a stroke-risk of 2% and 7%, respectively. Imaging transcranial Doppler (TCDI) sonography which uses the conventional ultrasound machine can also be used to predict the risk of stroke in children with sickle cell anaemia. It has also been shown that middle cerebral artery velocity measurements are the most reliable. The aim of this study was to determine age-specific cerebral blood flow velocity of children with sickle cell anaemia, and stroke risk category of children with SCA, prevalence of abnormal cerebral blood flow velocity using TCDI and also to determine the relationship between cerebral blood flow velocity and haemoglobin level. The study was hospital-based, cross-sectional, and case-controlled. It was carried out at the paediatric haematology clinic of Ahmadu Bello University Teaching Hospital, Zaria (ABUTH) and conducted over a twelve-month period from November 2015 to October 2016. Seventy-six children with SCA, Hb electrophoretic pattern SS, aged two to 16 years were studied. Seventy-six children with Hb electrophoretic pattern AA were the age- and sex-matched controls. Children with sickle cell anaemia in the two younger age groups of 2 – 4 years and 5 – 7 years had significantly higher cerebral blood flow velocity demonstrated by time averaged mean maximum velocity than their age- and sex-matched Hb AA counterparts (t = 5.01, p <0.001 and t = 3.57, p = 0.002) respectively. The cerebral blood flow velocity of children with sickle cell anaemia younger than 8 years is significantly higher than those aged 8 years and beyond (t = 3.26, p = 0.003). Increased cerebral blood flow velocities of varying degree beyond the normal acceptable value of 155 cm/sec revealed a Prevalence of 15.8% abnormal velocities and 5.3% conditional velocities among children with sickle cell anaemia. Normal imaging transcranial Doppler velocities were found in 78.9% of the children with sickle cell anaemia and all the Hb AA controls. There was significant negative correlation between cerebral blood flow velocity and haemoglobin level among children with sickle cell anaemia (r = -0.43, p <0.001). It is recommended, therefore, that children with sickle cell anaemia aged less than eight years and those with low steady state haemoglobin level should be considered of high priority for transcranial Doppler examination in resource-limited settings