Abstract: The incidence of cholelithiasis is high in the general population, which is related to ethics, food, living conditions and so on. In the aircrew who have passed the medical selection, the incidence of cholelithiasis is not less than that in the general population. Aviation-related physiological factors have special effects on the formation of cholelithiasis, which may endanger the aviation safety. Mechanisms, prevention and treatment of cholelithiasis in the aircrew are summarized in this review.