Gallstones are remarkably common. In the United States, roughly 14% of adults have gallstone disease, up from about 7% three decades ago. That means nearly 1 in 7 American adults is currently carrying gallstones, though most will never know it. Globally, prevalence varies enormously by region, ethnicity, age, and sex, but the overall trend is upward almost everywhere.
U.S. Prevalence Has Doubled in 30 Years
Between the late 1980s and 2020, gallstone disease prevalence in the U.S. rose from 7.4% to 13.9%. Over that same period, the rate of gallbladder removal surgery climbed from 6.0% to 11.6%. Two forces are likely driving this increase: worsening metabolic health across the population (more obesity, more diabetes) and the widespread adoption of laparoscopic surgery, which made gallbladder removal safer and more routine, prompting more people to get treated and therefore diagnosed.
Who Gets Gallstones Most Often
Women develop gallstones at consistently higher rates than men. A large global meta-analysis covering studies from 2000 to 2024 found a prevalence of about 7.3% in women compared to 5.3% in men. In some populations, the gap is much wider. In mainland China, for instance, prevalence runs about 11.3% in women versus 7.1% in men. Hormonal factors, particularly estrogen’s effect on cholesterol levels in bile, are a major reason for the difference. Pregnancy and oral contraceptive use further increase the risk.
Age is the other powerful predictor. People over 50 have gallstones at roughly 8.8%, compared to about 3.4% in those 50 and younger. The yearly rate of new gallstone formation jumps from about 0.2% per year before age 40 to 1.4% per year after age 60. After 40, the overall risk increases four to tenfold.
Ethnic and Geographic Differences
Geography and ancestry create striking disparities. Latin America and the Caribbean have the highest regional prevalence at about 15.4%, followed by North America at 8.4%. Europe, Central Asia, East Asia, and South Asia all cluster between 4% and 6%. The old assumption that gallstones were primarily a “Western” disease no longer holds. After 2000, prevalence in parts of Asia caught up to European levels, likely driven by dietary shifts and rising obesity rates.
Some indigenous populations carry an especially high burden. Among Mapuche Amerindians in Chile, nearly half of adult women (49.4%) have gallstones. In the general Chilean population, which has mixed European and Amerindian ancestry, the rate is still 36.7% for women and 13.1% for men. This points to a strong genetic component involving how the body handles cholesterol transport in bile. In the U.S., Hispanic Americans face elevated risk, while Black and Asian Americans have somewhat lower rates after adjusting for other factors.
Most Gallstones Never Cause Symptoms
Having gallstones does not mean you will feel them. The majority of people with gallstones remain asymptomatic for life. Long-term studies consistently show that only a small minority ever develop problems. A National Institutes of Health consensus report estimated that about 10% of people with silent gallstones develop symptoms within the first five years, and 20% within 20 years. That means 80% of people never have trouble over two decades of follow-up.
The rate of developing biliary pain (the cramping, right-upper-abdomen pain that signals a stone is temporarily blocking a duct) runs about 1 to 4% per year. That risk is highest in the early years after the stones form and gradually declines over time: roughly 2% per year for the first five years, dropping to 1% over the next five, and continuing to fall. Among those who do develop symptoms, about 20% will eventually progress to acute inflammation of the gallbladder if left untreated. Serious complications without any prior warning pain are rare.
Obesity, Weight Loss, and Other Risk Factors
Excess body weight is one of the strongest modifiable risk factors. An increase of just 5 BMI points raises gallstone risk by about 1.6 times in men and roughly 2 times in women. The mechanism is straightforward: higher body fat increases cholesterol secretion into bile, which makes bile more likely to crystallize into stones.
Paradoxically, losing weight very quickly also triggers gallstone formation. In a study of patients who underwent bariatric surgery, 36% developed new gallstones within six months of their procedure, and 13% developed sludge (a precursor to stones). Of those who formed stones, 40% became symptomatic. This happens because rapid fat breakdown floods the liver with cholesterol, and a gallbladder that isn’t contracting frequently (because the person is eating very little) lets that cholesterol-saturated bile sit and crystallize. The risk applies to any form of rapid weight loss, not just surgery.
Other factors associated with gallstone disease include diabetes, liver disease, and the use of proton pump inhibitors (common heartburn medications). Moderate alcohol consumption, interestingly, appears to lower risk slightly.
Gallstones Are Rising in Children Too
Gallstones were historically rare in children, but pediatric cases have increased significantly over the past two decades. Current estimates place prevalence in the pediatric age group between 1.9% and 4%. The rise closely tracks childhood obesity and diabetes rates. Increased use of abdominal ultrasound for evaluating stomach pain in kids has also led to more diagnoses that would previously have gone undetected. As a result, the number of gallbladder removal surgeries in children and adolescents has grown substantially.
How Gallstones Are Found
Because most gallstones are silent, they’re often discovered incidentally during imaging for something else, like an abdominal ultrasound or CT scan ordered for unrelated reasons. Ultrasound is the standard tool, detecting about 95% of gallstones. If you’ve been told you have gallstones but have no symptoms, the typical approach is simply monitoring. Surgery is generally reserved for people who develop recurring pain or complications, since the risks of an unnecessary operation outweigh the relatively low chance that silent stones will ever cause trouble.
For people who do develop symptoms, gallbladder removal is the definitive treatment. Over 2 million inpatient cholecystectomies were performed in one recent U.S. study period alone, with the largest share (about 42%) occurring in adults ages 18 to 49. The surgery is now done laparoscopically in most cases, with most patients going home the same day or the next.