Ten patients with sickle cell anemia over the age of 10 who had cholecystectomy are reported. All had symptomatic cholecystitis; three had biliary tract obstruction. Transfusions were given preoperatively and with attention to oxygenation and fluid and electrolyte balance. There were few complications, none serious. Based upon the frequency of gallstones over the age of 10, the likelihood of symptoms or serious complications and the apparent ease with which the properly prepared sickle cell patient comes through surgery, we recommend routine cholecystograms in all adolescent and adult sickle cell anemia patients with elective cholecystectomy for those who have stones.