Biliary system diseases are a common pathology in medical practice. A frequent situation in everyday practice is a patient with pain in the right upper quadrant, in which the suspicion of biliary disease is the first diagnosis to confirm or exclude. Ultrasound is a reliable method for the evaluation of the biliary system and is the first method of choice when a biliary disease is suspected. Ideally a correct examination of the gallbladder and the biliary tree is performed on fasting patients. The gallbladder is evaluated by means of right subcostal oblique sections while for the hilum evaluation sections perpendicular on the ribs are used. The structures are assessed regarding their size, wall thickness and content.