Sickle cell anemia is a devastating hematological disease leading to brain injury and neurocognitive deficits. Twenty-five patients (16 Hydroxyurea treated; 9 not) were imaged twice one year apart. Cortical thickness was assessed using FreeSurfer and compared between groups. Treated patients had thicker cortex in frontal and bilateral parietal lobes and in superior temporal and bankssts regions. Preservation of cortex in these regions may have implications for neurocognitive functions supported by associated networks such as central executive, attention and memory networks. These findings should be further evaluated for their impact on neurocognitive performance and Diffusion Tensor Imaging.