CONTEXT:Premarital haemoglobin screening is an important strategy for the control of Sickle Cell Disease. AIMS:To determine the prevalence and pattern of sickle cell disease among premarital couples and to assess their attitude to the risk of sickle cell anaemia in their offspring. SETTINGS AND DESIGN:A cross sectional descriptive study using interviewer administered questionnaire and haemoglobin screening to collect data. MATERIALS AND METHODS:Systematic sampling of every third premarital couples attending the General outpatient Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi, between November 2010 and October 2011 was used to select the subjects for the study. STATISTICAL ANALYSIS USED:SPSS version 16 was used for statistical analysis of data from 212 premarital couples or 424 subjects. RESULTS:The prevalence of HbAA and HbAS were 72.64% or 308/424 and 26.4% or 112/424, respectively, while HbSS was 0.94% or 4/424. In 95.3% of the couples there was no risk of offspring inheriting sickle cell anaemia. An equal percentage of males (χ2 = 24.704; df = 6; P = 0.000) and females (χ2 = 12. 684; df 6; P = 0.048) (67.9% or 144/212) would call-off their marriage if there was risk of their offspring being HbSS. CONCLUSIONS:Three quarters of the premarital couples had HbAA, while one quarter had Sickle cell trait. A very low percentage of the couples (2.8%) had 1:4 risk of their offspring inheriting SCA (HbSS). About 2/3 of the subjects would call-off the marriage if there was risk of their offspring inheriting SCA.