Leading experts Rabi Hanna, MD and Josu de la Fuente, PhD discuss key updates in sickle cell disease at ASH 2023. They cover topics such as disease biology, ongoing trials, and the growing role of gene therapy. They explore novel agents, pathogenesis, and potential therapies, highlighting improvements in natural history, mortality rates, and access to healthcare. The speakers also discuss advancements in treatment, including the reduction in vasoclecive events and hospitalizations, and the paradigm shift towards increasing fetal hemoglobin for management.