Subarachnoid hemorrhage (SAH) due to sickle-cell anemia is rare, but potentially devastating. However, with early recognition of SAH, aggressive support with exchange transfusion, cerebral angiography, and neurosurgical intervention, a positive outcome may be achieved. A case report of SAH managed in this fashion is reported. Based on similar cases in the literature, a suggested treatment protocol is provided for the management of nontraumatic SAH in sickle-cell patients presenting to the ED.