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Two young men whom were cousin referred  to our hospital  because of severe abdominal pain  ,started   after  mountain climbing over 2500 meter  height . The pain was severe and so they were not able to continue and had to come back. Pain did not been relived in spite of coming back and nausea and vomiting added to previous symptoms at night. Pain was spread to left shoulder and periumbilical region and had periodic changes in severity. There was no history of similar pain before. In Physical examination conjunctiva was pale and oral temperature was 38.1 Celsius in both of them. Para clinic tests revealed thrombocytopenia, high serum LDH level and mild elevation in AST and billirubin. Sonography in both of them revealed some hypo echo areas in inferior pole and middle part of spleen. According to history of pain during mountain climbing in highs, Sickle Cell Anemia (SCA) was the most probable diagnosis. Hemoglobin electrophoresis and Gen analysis confirmed diagnosis. Treatment with nasal oxygen and hydration with slain –dextrose serums were started. Sever pain controlled with opioid analgesics and relived gradually without any complication such as splenetic bleeding or rupture. Patients discharged with good condition after pneumococcal vaccination. 4 weeks later in follow up visit, general condition were good and vital signs had no abnormality. Physical examination did not show any significant findings .Spleens were slightly smaller than expected without any tenderness in percussion. Splenic infarcts had resolved gradually without any specific treatment or surgical intervention.