Based on screening ultrasonography of the gallbladder in 2756 men who received a retirement health examination at the Self-Defense Forces Fukuoka Hospital, Japan, during the period of 1986 to 1990, we compared serum lipid levels among 61 men with gallstones, 38 who had the gallbladder removed previously, and 2494 with a normal gallbladder. In univariate analysis, men having gallstones and those who had had a cholecystectomy had lower concentrations of total and low-density-lipoprotein (LDL) cholesterol than did control subjects, although the differences were not statistically significant. After adjustment for body mass index, smoking, alcohol use, and glucose tolerance, inverse associations of cholecystectomy with total and LDL cholesterol levels were more pronounced and statistically significant. There was no appreciable difference in high-density-lipoprotein (HDL) cholesterol and triglycerides between control subjects and men either with gallstones or after cholecystectomy. The present study did not support a positive relation between gallstones and serum triglyceride levels and an inverse one to HDL cholesterol, which have been reported elsewhere. The findings on total and LDL cholesterol are consistent with some, but not all recent studies.