Background/Aims: Cholelithiasis is a common disorder in north-eastern Germany. Analyses of risk factors for gallstone formation in this population may have high explanatory power. Gender-specific risk factors for gallstone formation and their interactions were investigated by using data of the population-based Study of Health in Pomerania (SHIP). Methods: Data of 4,202 persons aged 20-79 years were available. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on abdominal ultrasound. Multivariable analyses were performed to identify independent risk factors for gallstone formation. Results: There were 468 persons (11.1%) with previous cholecystectomy and 423 persons (10.1%) with sonographic evidence of gallstones. Women had a twofold higher risk for cholelithiasis compared to men. Age, body mass index and low serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, low alcohol and high coffee consumption and in the female population, low physical activity, were further independently related to gallstone formation. Additionally, sex-specific interactions between risk factors were found. Conclusions: Female sex, age and being overweight are major risk factors for gallstone formation in this region where cholelithiasis is a frequent disorder. Additional factors and interactions contribute to a gender-specific gallstone risk. Background / Aims: Cholelithiasis is a common disorder in north-eastern Germany. Analyzes of risk factors for gallstone formation in this population may have high explanatory power. Gender-specific risk factors for gallstone formation and their interactions were investigated by using data of the population -based Study of Health in Pomerania (SHIP). Methods: Data of 4,202 persons aged 20-79 years were available. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on abdominal ultrasound. Multivariable analyzes were performed to identify independent had a twofold higher risk for cholelithiasis compared to men. Age, body mass index (10.1%) with sonographic evidence of gallstone formation. and low serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, lo w alcohol and high coffee consumption and in the female population, low physical activity, were further independently related to gallstone formation. gallstone formation in this region where cholelithiasis is a frequent disorder. Additional factors and interactions contribute to a gender-specific gallstone risk.