Introduction. Sickle cell disease is a public health priority in France’s overseas departments (DOM), with the implementation of routine neonatal screening (NNS) and organized care beginning in the late 1980s. This article describes the epidemiological data on sickle cell disease in the various DOMs and the organization of care. Methods. The data presented are drawn from the 2010 report of the French Association for the Screening and Prevention of Childhood Disabilities (AFDPHE), the Hospital Information System (PMSI), and the activity reports of the various care facilities. Results. The incidence of major sickle cell syndromes at birth is 1 in 4,551 in Réunion, 1 in 633 in Mayotte, 1 in 343 in Martinique, 1 in 297 in Guadeloupe, and 1 in 227 in French Guiana. The prevalence of sickle cell trait carriers is 5.2% for all French overseas departments versus 2.7% for mainland France for the period 2006–2010. Changes in the organization of care, with clearly identified facilities, are presented for each department. Conclusion. Sickle cell disease is a common condition in the French overseas departments, with prevalence rates varying from one department to another. Migration patterns, non-adherence to follow-up among patients with mild or no symptoms, the precarious administrative status of many foreign patients, and geographical or communication challenges are responsible for many patients falling out of care. (R.A.)