Nineteen instances of intestinal obstruction caused by gallstones were observed in 17 patients. All patients were between 55 and 92 years of age, and 15 were women. Only 3 had had previous symptoms suggesting gallbladder disease. The possibility should be kept in mind whenever intermittent upper intestinal obstruction is encountered in an elderly, obese woman. In two of the 17 patients the condition recurred. After the ileus has been relieved by enterotomy and removal of the stone, it is necessary to consider elective cholecystectomy to prevent recurrences.