Gallstone disease is one of the most common clinical problems requiring surgical referral. The severity of gallstone disease ranges from asymptomatic cholelithiasis to rapid deterioration in severe cases of cholangitis or acute pancreatitis. Recognition of severe cases is critical to initiating timely management and improving outcomes. This chapter provides an overview of gallstone disease and its management; initial management and appropriate referral of patients with acute biliary sepsis; and an overview of normal recovery in patients discharged from surgical care and returning to their primary care physician.