Gallbladder stones will rarely lead to colic pain attacks and even more seldom to complications. A conservative watchful waiting strategy may be an alternative to cholecystectomy for uncomplicated symptomatic gallbladder stone disease. Evidence for whether the optimal treatment should be cholecystectomy or watchful waiting is weak. This narrative-condensed review critically analyses current evidence with special focus on epidemiological risk factors of developing symptoms or complications related to gallbladder stones. The evidence for treatment is discussed.