The State of Sickle Cell Disease: 2018 Report Card was created by sickle cell disease partners as a follow up to the previous report card which was released two years ago, in 2016. The 2018 Report Card is based on the feedback of more than 100 stakeholders in the SCD community and showcases a snapshot of the state of four major areas: access to care in the United States, training and professional education, research and clinical trials, and global issues. The report card indicates that initiatives like nationwide training programs for providers and recent legislation to enhance access to quality care have moved the needle in the right direction. While progress is being made, the report card also serves as a reminder that more can be done across many priority areas for individuals with SCD.