Background: Cameroon has high rates of sickle cell disease (SCD) attributed to lack of awareness among the reproductive age in the country. In Cameroon, the prevalence of SCD is 18.2% for the heterozygous form and 2.3% for the homozygous (HbSS) forms. Objective: This study determined the knowledge, attitude and practices of premarital counseling for sickle cell disease (PMCSCD) amongst Council workers of the Tubah, Bamenda I, II, III and City Council of North West Region of Cameroon, to see how this knowledge can be translated to intending couples to improve marital outcomes. Materials and method: A community based cross sectional study design with purposive random sampling was used to select Council workers who participated in the study. Data was generated by use of semi-structured questionnaires and presented using frequency, percentages and charts. Descriptive analysis was done using statistical package for social sciences (SPSS) software version 21. Relationship between variables was assessed using Chi-Square Test. We used a P-value of <0.05 as a cut off point for statistical significance. Results: A total of 59 respondents filled the survey. The result shows that knowledge of PMCSCD varied from one aspect to another, with an overall poor level. Attitude of respondents towards PMCSCD remained good (54.2%). Meanwhile implementation of PMCSCD in participants life was grossly inadequate (96.6%), with apparently no premarital counselor for SCD in any of the councils as reported by 83.1% of study participants. Out of the sociodemographic characteristics of interest, level of education was found to be significantly associated with knowledge (X2=17.5; P= 0.04). The survey also found a significant association between participants attitude and sex, age group and marital status. No sociodemographic factor was found to be associated with practice. Conclusion: Overall, council workers had poor knowledge of PMCSCD. Attitude of workers towards PMCSCD was good. Practice of PMCSCD among study participants remained poor. This suggests that council authorities should take advantage of this information and pull attention to potential areas for intervention and improvements in knowledge of man power resources especially true in relation to sickle cell disease counselor so that the knowledge can be translated to intending couples to foster better outcomes in sickle cell prevention, awareness and management.