Biliary lipids of a case who developed in cholecystolithiasis 3 years after ileostomy were analyzed. The hepatic bile in this patient was supersaturated with cholesterol, secondary to the low bile acid pool after ileostomy. Therefore, care must be taken for the development in cholesterol gallstones after ileostomy or ileal resection. Preventive administration of the dissoluble agents for cholesterol gallstones is recommended in the patient with ileostomy or ileal resection.