Background: Sickle cell disease is a common hereditary hemoglobin disorder in southern Saudi Arabia. The current models of health care provision and health service utilization are not homogeneous across the kingdom. Aim: The current models of health care provision and health service utilization in a single center in our region were audited to evaluate the current provided healthcare services and suggest improvement if needed. Methodology: In this retrospective chart review study, from 2015 to 2019, all patients with sickle cell anemia admitted to a tertiary care hospital were enrolled in the study. All related data including demographics, laboratory interventions, and management procedures were collected. Descriptive analysis and statistical tests of association were performed. Results: One hundred and twenty-one patients were admitted 165 times over the study period. Vaso-occlusive pain episodes was the most commonindication (58%) for admission, followed by hepatobiliary (16%), and pulmonary complications (12.7%). Most of the provisioned services were of nonspecialized medical or surgical specialties. Blood transfusion was overused (64%), whereas adequate hydroxyurea (HU) therapy was underused (25%). Conclusion: The current study offers a glimpse of some gaps between the current practice and the established local, national, and international guidelines in terms of underutilizing HU and over utilizing blood transfusion. Comprehensive care centers were not available, and care was provided mainly by nonhematologists. Educating health providers and establishing comprehensive care centers would enhance the current model of health care provision.