One hundred eighty-three young Saudi females (92 patients with gallstones, 91 controls) mean age and (SD), 30.2 (6.1) and 29.7 (6.4) years respectively were studied in detail for possible risk factors for gallstone formation. No statistically significant difference was found when the two groups were compared with regard to past history of jaundice. HBsAg carrier status, use of oral contraceptives, parity, diabetes mellitus, obesity (as Body Mass Index > 30), hypercholesterolemia and hypertriglyceridemia. However, it was noted that both groups were overweight; mean (SD) BMI of 27 (5.9) and 26.7 (6.8) for patients and controls respectively and both had high parity rates; mean and (SD) pregnancies of 4.7 (2.6) and 4.3 (2.9), respectively. Family history of gallstones in first degree relatives of patients was significant (.0027 < P < .01) more than in the controls (95% confidence interval of 3% to 23%). This may suggest a genetic or an environmental factor that strikes the balance toward gallstone formation in the obese and fertile young female population. A larger nationwide, population-based study is surely justified and needed.