Introduction: The goal of this retrospective cohort study was todetermine current patterns in the use of ultrasound and CT in the evaluation of patients withacute gallbladder disease at a single institution, and to determine patient and hospitalcharacteristics that predict inappropriate use. Materials and Methods: Demographic data of each patient such as name, age, gender etc. was recorded. Gall bladder examination was performed with a 3.5-5 MHz probe by scanningin subtotal position. Hospital variables included the time and day of the week the patient was evaluated in the ED, previous ED visits for gallstone disease, and admitting service. Detailed data on radiologic studies including performance of each study and the findingswere recorded. Studies included right upper quadrant ultrasound, abdominal CT, hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance cholangio pancreatography (MRCP) and endoscopic retrograde cholangio pancreatography(ERCP). Results: Common pathologies were gallstone with sludge in 50, cholecystitis in 37, polypsin 22 and benign tumors in 15patients. The difference was significant(P< 0.05). Conclusion: Author found that ultrasound is non-invasive and the least expensive imaging modality that is highly sensitive and specific in the assessment of the gallbladder wall and luminal content.