Gallstones develop in approximately 10% to 15% of the US population and represent one of the most common and most costly of all digestive diseases. Studies investigating gallstones' natural history have shown that gallstone-related complications arise at a rate of approximately 1% per year in asymptomatic patients and 2% per year in patients who already have symptoms. Patients can have any of multiple presentations with gallstone-related problems along a continuum of health threats from intermittent biliary colic to septic shock from ascending infections. In most clinical situations in which the patient's gallstone symptoms are either recurrent or have caused complications, cholecystectomy remains the procedure of choice. Laparoscopic cholecystectomy, first performed in the mid-1980s, has quickly become the gold standard in the US. For clinicians who perform abdominal procedures, the literature is consistent in advocating cholecystectomy for gallstones found incidentally during other abdominal procedures.