We report a case of a 34-month-old girl who has been followed up for 12 months after ingesting 105mg/kg of hydroxyurea (HU) and showed only transient mild bone marrow suppression. With anticipated increase in HU use among children with SCD in sub-Saharan Africa, the possibility of accidental ingestion should be envisaged and appropriate user-education and management guidelines established. Toxicity from accidental HU overdosage is generally mild and transient and should not constitute a barrier to its use in Nigerian children with SCD.