Background: Sickle cell anemia, hereditary spherocytosis, and thalassemia are hemolytic anemias that cause considerable changes in the spleen because of chronic hemolysis and changed blood circulation. Knowledge of the physiological, biochemical and histopathological alterations of the spleen of patients who developed enterovirus infection establishes the pathophysiologic processes of the disease in the pediatric population. Objective: To understand the pathophysiology of sickle cell anemia, this study aimed at comparing physiological, biochemical and histological differences in the spleen of pediatric patients with different type of hemolytic anemias.