Objective: To evaluate the structure, development and family functionality living with sickle cell disease. Method: This is qualitative study that used as the theoretical framework Calgary Model of family assessment and as methodological strategy the case study. Data were collected from six families of children with sickle cell disease, attended by a Hemonúcleo of Hematology Center Foundation and Hemotherapy Minas Gerais (Hemominas), located in Minas Gerais, Brazil, from September/2014 to February/2015, through pre-designed instrument, beyond semistructured interviews and participant observation, with register in daily of field. Examined by means of thematic analysis e, the categories theoretical framework adopted agreed. Results: It was verified that four families composed a nuclear model; the others two families were of the extended type. Conflicting subsystems been present in only family and all had presented in its net of support deriving elements of neighbors and members of the extensive family. In the assistance process, it was evidenced that the six families presented insufficient support of the health services and, for the solution of problems, the families evaluated showed empowerment in the face of the time of discovery due to their previous experiences. Conclusion: This study the child with sickle cell disease and its family can be used for the nurses in accordance with to subsidize the planning of the work in the care, making possible the elaboration of personalized interventions the functioning of the familiar dynamics.