Gallstones form silently in many adults and stay asymptomatic for years. When they obstruct the cystic duct or common bile duct they cause biliary colic, acute cholecystitis, or gallstone pancreatitis. Symptomatic gallstones are an indication for laparoscopic cholecystectomy. Asymptomatic stones are usually observed unless specific high-risk features are present (porcelain gallbladder, large stones, polyp coexistence, sickle-cell disease).