The literature of the past ten years is replete with articles on "routine* cholangiography, with particular reference to the overlooked or "unsuspected" stone. Many series do not differentiate between T-tube cholangiograms performed after common duct exploration and those performed on patients with and without the usual clinical or operative indications for common duct exploration. We present a pure operative cholangiographic study of 354 patients with apparent uncomplicated bilary tract disease; a significant incidence of unsuspected pathologic features are demonstrated. Can a convenient and innocuous procedure like routine operative cholangiography continue to be ignored, even in the most routine of cases?