The objective of this study was to evaluate knowledge, attitudes and beliefs (KAB) that may influence health seeking behaviour of caretakers of children with sickle cell disease (SCD). A cross-sectional survey was undertaken at Nyanza provincial hospital in Kenya between March and September 1993 to identify socio-demographic and economic factors that may influence health seeking behaviour of primary caretakers of children with SCD. All caretakers accompanying children under the age of 18 years to the Sickle Cell Clinic were eligible. Guardians accompanying children to the clinic were interviewed using pretested questionnaires. An exploratory factor analysis method was used to categorise questionnaire items into domains (knowledge, attitude and belief) and to investigate for association between certain socio-demographic factors and KAB. Seventy five per cent of the 108 respondents interviewed were mothers and 16.7% fathers. Seventy eight percent knew SCD to be hereditary while 55% knew how the disease presents in childhood. Only 42% associated SCD with increased risk of infection. Many felt severe infections are largely preventable and that prevention would reduce their anxiety and illness related costs. In factor analysis, variables loaded almost exclusively on "Attitudes" and "Beliefs" factors. Only family size was found to influence caretaker attitudes (p = 0.0095) and beliefs (p = 0.0034). Education, monthly income, occupation and religion had no significant influence. The majority of caretakers had good knowledge and positive attitudes towards SCD in children. Interventions aimed at management of SCD or prevention of its sequelae would be well accepted. Factor analysis is recommended for statistical analysis of KAB data. The effect of family size on attitudes and behaviour needs further evaluation.