The purpose of this study was to determine if the growth retardation often associated with sickle cell anaemia could be related in part to a deficiency of essential fatty acids. We reported recently that children with sickle cell disease in Jos, Nigeria have lower levels of serum amino acids and higher levels of urinary amino acids than their healthy counterparts. In the current study, we determined that the serum phospholipids of children with sickle cell anaemia did not deviate in the proportions of the essential fatty acids, linoleic and alpha-linolenic they contain compared to controls. However, their serum phospholipid profiles were significantly different in the proportions of four other fatty acids. Specifically, the phospholipids of children with sickle cell anaemia contained 19 per cent more palmitic acid (P = 0.006), 22 per cent more oleic acid (P = 0.014), 18 per cent less arachidonic acid (P = 0.008), 51 per cent less eicosapentaenoic acid (P = 0.0008), and 43 per cent less decosahexaenoic acid (P = 0.001). These data show that children with sickle cell anaemia are not deficient in essential fatty acids, but that the fatty acid elongation and desaturation pathway is somehow disturbed in this disease.