Fatty pancreas, which can be evaluated with radiological methods, is a frequently overlooked finding. The aim of this study was to use endoscopic ultrasound (EUS) to evaluate whether there was a relationship between fatty pancreas and cholecystolithiasis, similar to the relationship between fatty liver and cholecystolithiasis, which has been previously shown in literature. Methods: The study included 50 cases with calcular gall bladder disease and 50 subjects without. All cases underwent EUS evaluation due to different indications. Besides routine patient evaluation, pancreatic and liver echogenicity was graded in comparesion to the spleen at the time of EUS using a specified grading scheme. Results: In this case-control study, we found no significant difference between the two groups regarding patient’s gender or age. Fatty pancreas was significantly higher in patients with calcular GB disease (34%) than the control group (12%) P- value:0.009. Similarly, fatty liver was significantly higher in patients with GB stones (46%) than in the control group (14%) P- value:0.001 and presence of diabetes or hypertension was strongly associated with GB stones P- value <0.05 Conclusion: Using EUS in the present study has revealed higher rates of fatty liver and fatty pancreas in cholecystolithiasis cases than control group. Large-scale longitudinal studies with large number population will be able better evaluate the relationship between cholecystolithiasis and fatty pancreas.