During a two year period, 1981 to 1982, 21 of 262 patients undergoing cholecystectomy had acalculous cholecystitis. The majority of these patients had chronic disease, and more than 50 per cent of them were in the older age group and had other chronic medical problems. The signs and symptoms are similar to that of calculous cholecystitis, although the cause is unclear. However, the patient with these complaints deserves thorough evaluation in order to rule out other disorders of the upper part of the gastrointestinal tract, because cholecystectomy for chronic acalculous cholecystitis will relieve the symptoms in more than 80 per cent of the patients. Acalculous cholecystitis is a true organic problem which, if diagnosed accurately, can be effectively treated with cholecystectomy.