The review assessed the clinical effectiveness and cost-effectiveness of primary stroke prevention treatments for children with sickle cell disease (SCD) who were identified by transcranial Doppler (TCD) ultrasonography to be at high risk of stroke. The review examined the existing health economics evidence and identified the key economic issues related to primary stroke prevention treatment in clinical care for this group of patients. A de novo economic model was developed and populated to evaluate the cost-effectiveness of TCD ultrasonography with blood transfusion as a primary stroke prevention treatment within the NHS.