Ultrasound examinations of 76 patients with suspected gallbladder disease were compared with radiographic, surgical, and pathologic findings to determine the accuracy of the ultrasound examinations. In 13 of the 76, the gallbladder was not visualized by ultrasound. Diagnosis of the presence or absence of gallstones was correctly made by ultrasound in 56 of 63 visualized gallbladders, for an accuracy rate of 89%. A high proprtion of nonvisualized gallbladders (10 or 13) contained gallstones. Previously unreported ultrasound findings of a stone impacted in the proximal cystic duct and findings of a collection of bile in the lesser sac associated with cholelithiasis and choledocholithiasis are illustrated.