New endoscopic and radiological techniques, together with pharmacological developments, prompted by high-surgical risk patients or those developing bile duct stones after prior cholecystectomy--but also by the wish to have less invasive alternatives available, have led to a variety of non-operative therapeutic modalities in gallstone diseases. Both endoscopic and radiological procedures are employed to remove stones from the biliary tract and gallbladder. Extracorporeal lithotripsy and chemical litholysis are being increasingly employed to treat gallbladder stones. Laparoscopic cholecystectomy is a new operative possibility. These different approaches, sometimes used in combination, are associated with different preconditions for success. Indications and results must be measured against the gold standard of cholecystectomy.