With the development of new gray scale signal processing, a high level of accuracy has been obtained with gallbladder sonography. Biliary calculi seem to be more prevalent in the pediatric population than is generally appreciated. Two interesting features of childhood cholelithiasis are the increased incidence in patients without hemolytic anemia and the uncommonly high percentage of gallstones visible with plain roentgenograms of the abdomen. Cholecystosonography is offered as an additional method of establishing diagnostic certainty.