Sickle cell proliferative retinopathy usually presents first in the peripheral retina and the ability to extend and enhance our visualization of the peripheral retina would allow for superior clinical decision-making. In our practice, we had a 28-year-old patient diagnosed with major sickle cell disease of the homozygous type SS (HbSS) that presented with sickle cell proliferative retinopathy detected by ultra-widefield imaging in the nasal side of the left fundus. At follow-up, neovascularization was detected in the extreme nasal periphery of the left eye by ultra-widefield imaging fluorescein angiography with right gaze. The case was graded as Goldberg stage 3, and the patient was administered photocoagulation treatment. With further advancements in the quality and modality of peripheral retinal imaging, novel proliferative lesions can be detected and appropriately managed much earlier than was previously possible. Ultra-widefield imaging allows for the visualization of the central 200 degrees of the retina but, with gaze view, peripheral retina beyond 200 degrees can be reached.