Biochemical analysis of serum and bile from patients with cholelithiasis hailing form north-eastern India was done to provide pointers for lithogenicity. In comparison to controls, patients with cholelithiasis showed significant increase in serum phospholipid levels and lecithin cholesterol acyl transferase activity was significantly decreased. Enzymes like gamma glutamyl transferase, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase showed a small though significant increase as compared to controls, suggesting evidence of subclinical hepatic dysfunction and probable evidence of relative bile stasis. Levels of cholesterol, lecithin and lecithin cholesterol acyl transferase activity were seen to be increased in gall bladder bile as compared to hepatic duct bile.