Background/Aims: The incidence of gallstone has been presumed to be influenced by the social and economic environment. The aim of this study was to clarify the epidemiological and clinical characteristics of gallstone disease in Korea. Methods: The authors reviewed the medical records of 1,040 surgically proven gallstone patients at the SNUH from 1991 to 1995 (period III) and compared these results with previous reports of 831 gallstone patients from 1981 to 1985 (period I) and 888 patients from 1986 to 1990 (period II). We integrated this data with previous reports that reviewed 2,252 cases of biliary calculi in Korea from 1961 to 1980. The results are summarized as below. Results: The incidence of gallstone was increased in late 15 years. The proportion of GB stone was increased. But that of CBD stone was decreased. There was no change in the proportion of IHD stone. Female preponderance was not so striking as in western country. GB stone group was more obese than that of other stones. The difference between urban and rural residents was reduced. Conclusions: This study showed that the pattern of gallstone disease was changing to that of westernized country but IHD stone was unique problem to Korea. (Korean J Gastroenterol 1998; 31: 100 - 106)