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Sickle cell disease may manifest as occlusion of arterial retinal vessels during a vaso-occlusive crisis, which can have multiple triggers. In this case, the patient had a simultaneous bilateral branch retinal artery occlusion, following physical activity, due to a sickle cell crisis. Timely treatment was started with exchange transfusion and erythrocytapheresis, which resulted in marked improvement of visual acuity and visual field over a 3-month follow-up. This case enlightens the importance of early recognition and communication with other medical specialties for prompt initiation of treatment and better functional results in a disease that is vision-threatening and normally associated with poor prognosis. In addition, this case emphasises the need for regular follow-up on patients with sickle cell disease to detect early signs of retinopathy and to alert patients to symptoms like episodes of transient loss of vision and the presence of scotomas.