Fetal cholelithiasis, reported as echogenic material in fetal gallbladder, is an infrequently
encountered condition. Association of fetal cholelithiasis with beta-thalassemia is rare. We
report incidental detection of cholelithiasis in a fetus during routine antenatal ultrasonography
at 39 weeks of gestation. The gallstones persisted beyond the neonatal period, and the
infant was later diagnosed as beta-thalassemia major. Both the parents were known cases of
beta-thalassemia trait with their earlier two children diagnosed as beta-thalassemia major.
We highlight the importance of awareness for the treating physician about this uncommon
complication of beta-thalassemia major,while managing an apparently asymptomatic
neonate.