A retrospective chart review of 507 patients who underwent cholecystectomies over an 18 month period was performed. There were 345 female patients and 162 male patients. Of the female patients, 90 (26 percent) presented with complicated disease, which was severe in 38 (11 percent). The mortality rate was 0.87 percent in the total group of female patients (3 deaths), or 7.9 percent in the 38 patients with severe disease. In the male patients, on the other hand, 96 (59 percent) presented with complicated disease, which was severe in 57 (35 percent). There were 6 deaths, for a mortality rate of 3.7 percent in the total group of male patients, or 10.5 percent in the 57 patients with severe disease. This study supports our observation that biliary tract disease is more life-threatening in men. It appears that elective cholecystectomy should be considered in the male patient who presents with asymptomatic cholelithiasis.