© 2019 Editorial Delirio. All rights reserved.Aim: Although there are significant increase in the incidence of gallstone disease in children, studies performed on this issue are limited in number which does not suffice to formulate a guideline Therefore, we aimed to reveal risk factors related to gallstones developed during childhood, determine factors effective on its severity of symptoms,and share our experience on the management of gallstones in pediatric patients. Material and Method: The medical records of children who underwent cholecystectomy for gallstone disease were reviewed retrospectively regarding demographic features, medical history, results of radiologic examinations and laboratory tests, operative and clinical findings. The severity of symptoms related to gallstone disease were scored based on symptom scoring system and intergroup differences in symptom scores of the groups were compared. Results: Our study included 147 (75 boys, and 72 girls) patients, including 75 boys and 72 girls. The incidence of gallstone disease was higher in male infants and in adolesents girls. The incidence of gallstone, body mass index and syptom score averages (SSA) were higher in older girls. There were 35 (23.8%) asymptomatic, 112 (76.2%) symptomatic patients in our series and 54.4% of our patients had a risk factor and the most common risk factor was the presence of an associated hematologic disease. The SSA scores were significantly higher in patients with idiopathic gallstones. SSA and the risk of pancreatitis were higher in patients with millimetric stones. In our study a significant increase has been observed in the rates of cholecystectomy performed with the indication of gallstone. Conclusion: According to our experience, female gender, age and excess weight are important risk factors for gallstone disease during adolesance. Based on our results of symptom scoring in pediatric patients it can be concluded that factors as female gender, advanced age, excess weight, idiopathic factors, multiple or milimetric gallbladder stones increase the clinical severity of gallstone disease.