A review of the most recent literature on biliary tract disease in sickle cell (HbSS) disease has shown gallstones to be present in approximately 67 percent of affected patients. There is adequate evidence to urge all physicians to be aware of the contributions of gall bladder disease to the abdominal symptoms of sickle cell anemia. Frequently, because it is difficult to distinguish between the painful "crises" and gall bladder disease, the latter diagnosis is not considered.This article submits that investigative procedures of the gall bladder, in all patients with HbSS disease and abdominal crises, should be performed. If gallstones are present, elective cholecystectomy in the adequately prepared patient seems to be justified.