The immunocytochemical distribution of vasoactive intestinal peptide (VIP) was studied in healthy and diseased regions of the human gall bladder wall obtained after operation for cholelithiasis. Ganglionated plexuses containing VIP-like immunoreactive nerves and fibers were located in the subepithelial and muscle layer of the normal region, suggesting that VIP may exert gall bladder function, while such ganglionated plexuses were almost absent, being replaced by inflammatory cells and fibrotic tissue. This suggests that the lack of VIP may be one of the causes in the pathogenesis of gall bladder dysfunction in the case of cholelithiasis associated chronic cholecystitis.