Background: Gallstone disease called as cholelithiasis is the most common digestive surgical disorder and account for an important part of health care expenditure. Aim: This work was carried out to study the diverse histopathological changes in the gallbladder mucosa as a result of cholelithiasis. Materials and Methods: This was a retrospective study carried out in the Department of Pathology, Dr. Hedgewar Arogya Sansthan Hospital during a period of 1 year. The study included 184 cases of cholecystectomy specimens. Results: There was a preponderance of females (M : F ratio 1: 1.5). The age of the patients varied from 23 to 76 years with a mean age of 47 years. On macroscopic examination, the serosal surface of the gallbladder was found normal in 126 specimens (68.48%) and congested in 58 specimens (31.52%). Gallbladder wall thickness was normal (__ampersandsignlt;3mm) in 107 specimens (58.15%) and thickened (__ampersandsigngt;3mm) in 77 specimens (41.85%). Mucosa was normal in 121 (65.76%), hemorrhagic in 23 (12.50%), Strawberry like in 34 (18.48%) and slightly nodular in 6 specimens (3.26%). On microscopic examination, normal epithelium was seen in 34 specimens (18.48%), epithelial hyperplasia was observed in 85 (46.20%), intestinal metaplasia in 47 (25.54%), cholesterolosis in 14 (7.61%) and dysplasia in 4(2.17%) specimens. Conclusion: Gallstones are accompanied by major changes in the gallbladder epithelium. The morphological spectrum of gallstone disease will certainly contribute to understand its etiopathogenesis and hence prevention.The relation between the observed changes and gallstone formation needs further studies.