Patients with chronic anemia has been shown to be susceptible to structural, functional and cognitive impairments. This study explores differences in white matter microstructure (measured by ADC) and cerebrovascular perfusion patterns (measured by MTT) and their relationship to hemoglobin in patients with sickle cell anemia, non-sickle anemia and controls. Larger ADC values and faster MTT is found along the anterior circulation of the brain in sickle-cell anemic patients. Relationships were found between hemoglobin, ADC and MTT in controls that were not observed in sickle-cell patients possibly indicating microvascular dysregulation. Our observations indicate possible microvascular dysregulation in sickle cell anemic patients.