['To identify factors associated with asthma associated with increased sickle cell anemia (SCA).', 'Children with SCA (N\xa0=\xa0187; mean age 9.6\xa0years, 48% male) were classified as having "asthma" based on parent report of physician diagnosis plus prescription of asthma medication (n\xa0=\xa053) or "no asthma" based on the absence of these features (n\xa0=\xa0134). Pain and acute chest syndrome (ACS) events were collected prospectively.', 'Multiple variable logistic regression model identified 3 factors associated with asthma: parent with asthma (P\xa0=\xa0.006), wheezing causing shortness of breath (P\xa0=\xa0.001), and wheezing after exercise (P\xa0<\xa0.001). When ≥2 features were present, model sensitivity was 100%. When none of the features were present, model sensitivity was 0%. When only 1 feature was present, model sensitivity was also 0%, and presence of ≥2 of positive allergy skin tests, airway obstruction on spirometry, and bronchodilator responsiveness did not improve clinical utility. ACS incident rates were significantly higher in individuals with asthma than in those without asthma (incident rate ratio 2.21, CI 1.31-3.76), but pain rates were not (incident rate ratio 1.28, CI 0.78-2.10).'] Are wheezing symptoms and parental asthma associated with a physician diagnosis of asthma in children with sickle cell anemia?