Sixty-four patients suspected radiologically to have gallstone disease were evaluated for clinical symptoms, physical findings and laboratory abnormalities. Fifty-three of them had ultrasound examination which confirmed the diagnosis in 52 (98.1%). An attempt was also made to identify possible predisposing factors. Sixty of these patients underwent cholecystectomies, with common duct exploration in 10 of them. On visual assessment at surgery, 96.6% of the stones were thought to be cholesterol in type. X-ray powder diffraction analysis of 30 different samples confirmed all to be cholesterol. We conclude that cholesterol gallstone disease, presenting with the usual clinical features, is a common health problem among Ethiopians. We feel that ultrasonography should be used more often for the diagnosis of this disease.