Some studies show an approximately two to threefold increased incidence of cholelithiasis in cirrhotic patients as compared to the non-cirrhotic population. In this study, the incidence of gallstones, acute cholecystitis and cholelithiasis related mortality have been investigated in patients with chronic liver disease. Seventy two patients with liver cirrhosis were included in the study. Nineteen of the patients (26%) had cholelithiasis and 12 of these had acute cholecystitis (63.1%).Seven patients underwent surgery of whom three requiring emergency cholecystectomy died of sepsis and hepatic failure in the early postoperative period. There was only one death amongst the four patients who underwent elective cholecystectomy. Overall mortality in patients with acute cholecystitis and liver cirrhosis was 41%. The mortality in patients classified as belonging to CHILD A, B or C groups was 0%, 40% and 57% respectively.Emergency cholecystectomy carries greater risk in patients with advanced liver disease and those patients with symptomatic stones may better benefit from elective operations at an early stage in their liver disease.