Pica is the developmentally inappropriate consumption of non-nutritive items for at least one month. Pica can lead to many adverse outcomes, but the exact pathophysiology of pica is unknown or variable across populations. Several studies have evidenced that there is a high prevalence of pica among youth with sickle cell disease (SCD). The overall aim of this study was to examine correlates of pica in pediatric SCD from a biopsychosocial framework. Qualitative (n = 21) and quantitative methods (n = 58 children with SCD and pica) were used to describe a sample of children with SCD and pica. Additionally, exploratory comparisons were conducted between children with SCD and pica and children with SCD without pica (n = 55) to examine relationships between hypothesized contributing variables and pica. Results supported the relationship between several psychosocial variables and pica and highlighted areas and methods for future research in this area. Additionally, clinically implications informed by this study are discussed.