We present a prospective evaluation of the diagnostic value of 37 symptoms and signs of gallstones in 192 patients admitted with upper abdominal pain. The study was carried out independently of the examination and treatment by the staff. The routine investigations showed 49 patients with gallstones. Univariate analysis showed that old age, previous similar attacks of pain, previous intolerance to fatty foods, severe (that is, requiring analgetic injections) and radiating pain, and tenderness in the upper right quadrant were significantly more frequent in patients with gallstone disease than in those without. The evaluation showed that the classical signs and symptoms are relatively poor in establishing the diagnosis of gallstone disease, but their absence is a relatively good indicator for excluding the diagnosis. The multivariate analysis showed that the diagnosis of gallstone disease depends, in the main, on intolerance to fatty foods, severe pain, and tenderness in the upper right quadrant. The other classical signs and symptoms depend on and vary mutually with these three.