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This study was designed to examine the relationships of demographics, anthropometrics, prenatal physical activity, serum cholesterol, and nutrient intakes to symptomatic cholelithiasis (gallstone) occurrence in 128 northern plains pregnant women. Data collected at 14 and 26 weeks of pregnancy and 4 weeks after delivery, indicated 25.8% of the Native American and 8.3% of the Caucasian pregnant women experienced symptoms of cholelithiasis. Body mass indices (BMIs) were significantly higher in the pregnant women who experienced cholelithiasis than in those who did not have cholelithiasis, and prenatal physical activity was significantly lower in those same women. History of gallbladder disease (β = .73; p = .001), BMI (β = .33; p = .01), and prenatal physical activity (β = −.20; p = .04) were predictive of increased occurrence of cholelithiasis during pregnancy. © 2004 Wiley Periodicals, Inc. Res …