Biliary tract disease associated with calculi (gallstones) causes much disability and shortening or curtailment of life. At present there is insufficient knowledge to prevent the occurrence or development of gallstones. With the accomplishments of recent decades in preventing such diseases as typhoid fever, tetanus and poliomyelitis, and the control of many infections such as pneumococcal pneumonia, osteomyelitis and bacterial endocarditis, it is anticipated that at some time in the future gallstones will be prevented or eradicated by nonsurgical methods. Until then, surgery provides the most effectual means of interrupting the disease process and curtailing or preventing concomitant serious complications. The author believes that early diagnosis of gallstones followed by prompt removal of the gallbladder is the best approach to this health problem at present.