Biliary lithiasis is one of the most common biliary pathothogy with a reported prevalence of approximately 6%-12%. The pathogenesis of biliary lithiasis is complex and a multifactorial process involving factors which affect the bile content and bile flow. Hypersaturation of bile with cholesterol and biliary stasis have been shown to be crucial factors in development of biliary stones. Hypothyroidism has a worldwide population prevalence of 4%-5%. It leads to decrease in liver cholesterol metabolism causing serum hypercholesterolemia with 90% of hypothyroid patients having elevated cholesterol levels; approximately 50% higher than in euthyroid patients. This hypercholesterolemia may result in hypersaturation of bile with cholesterol. Cholesterol hypersaturation of bile results in impaired motility, decreased contractility and reduced filling of the gallbladder causing prolonged stay of bile in the gallbladder contributing to retention of cholesterol crystals which may lead to nucleation and continuous growth into mature gallstones. Biliary stasis is also caused by sphincter of Oddi dyskinesia leading to formation of gallbladder and bile duct stones. Several hormones have been shown to affect spincter of Oddi activity including thyroid hormones. Thyroid hormones have been shown to have a direct pro-relaxing effect on sphincter of Oddi and lack of this effect in hypothyroidism may result in delayed bile flow which may lead to the formation of biliary stones. An increased prevalence of hypothyroidism (13.3%) among biliary stone disease patients was found in our study, with prevalence rate being comparatively higher in CBD stone patients. Hypercholesterolemia was found in 91.67% of the patients having hypothyroidism.