Cardiovascular abnormalities have become more evident in children with sickle cell anaemia (SCA) with prolonged survival due to advances in sickle cell disease management. A proper evaluation of the cardiovascular status with the view to ensuring early intervention where necessary is an important approach to improving their quality of life. Though, previous studies had given varying reports of the cardiovascular status of children with SCA using electrocardiography (ECG) and echocardiography; serum brain natriuretic peptide (BNP) [a cardiac biomarker], which had rarely been explored in SCA children, has qualities of a desirable early screening tool. This study was thus aimed at determining the spectrum of the cardiovascular abnormalities in children with SCA in steady state at the University of Ilorin Teaching Hospital; describing the ECG and echocardiographic findings in SCA children and comparing these with the findings in controls, as well as determining the predictive value of serum BNP for the ECG and echocardiographic abnormalities in the subjects. This was a comparative cross-sectional study in which 95 children aged two to eighteen years with sickle cell anaemia in steady state and 95 age and sex matched controls were recruited. Sociodemographic, anthropometric and relevant clinical data were obtained from both groups and their cardiovascular status was determined by electrocardiography, echocardiography and their serum BNP levels. Serum BNP was determined using the principle of competitive enzyme immunoassay. Subsequently, the severity index score of the subjects was generated from relevant clinical details. The obtained data was analyzed using the SPSS 20.0 software package. The age range of both subjects and controls was 2-18 years with mean ± SD age of 8.8 ± 4.3years in each group (p = 1.00). A comparison of the social class of the subjects and controls showed a higher proportion of the subjects belonged to the upper social class compared to the controls (67.4% vs 14.7%; p < 0.001). The commonest cardiovascular related clinical features were pallor, systolic murmurs, displaced apex and tachycardia which were recorded in 56 (58.9%), 53 (55.8%), 32 (33.7%) and 17 (17.9%) subjects respectively. The percentage of subjects with ECG and echocardiographic abnormalities constituted 42.1% and 83.2% respectively. Prolonged corrected QT interval was the most common ECG abnormality which was detected in 16.8% of subjects while the commonest echocardiographic abnormality was left ventricular hypertrophy, detected in 60 (63.2%) of the subjects. The median (IQR) BNP levels of children with SCA in all age categories were not significantly different from those of controls (each p > 0.05).