Sickle cell disease (SCD) is the most common inherited disease worldwide and presents with a myriad of complications1. A rare complication of SCD is acute soft head syndrome (ASHS). We present the case of a 14-year-old male with homozygous sickle cell anemia (HbSS) who presented with vaso-occlusive crisis (VOC) complicated by the peculiar development of a scalp mass. Magnetic resonance imaging (MRI) showed calvarium changes consistent with ASHS. Current literature lacks standardized management for such a complication. As such, we outline recommendations for imaging modalities, therapeutic interventions, and ongoing management based on this patient’s course over two years.