Gallbladder disease is a very common diagnosis and implies great economic cost. Gallbladder disease is a multifactorial process involved with host and environmental factors. Obesity is considered one of the most important risk factor associated with gallstone disease and is very important mainly due its increased prevalence worldwide. Several changes in cholesterol metabolism tend to increase gallbladder cholesterol secretion in conjunction with motility disturbances, which aids in gallstone growth. In this work, epidemiologic and pathophysiologic factors related with obesity and gallstone disease are discussed.