The knowledge of gallstone disease (GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.