Abstract Background: Chronic liver diseases in the pediatric age group are rather a common problem with minimal symptoms yet carries the risk of considerable morbidity and even mor-tality, especially in developing countries. Chronic liver diseases are diagnosed if clinical or laboratory data of liver dysfunction persist for more than six months. Aim of Study: Our study aimed to evaluate the gall bladder ultrasonographic changes in children with chronic liver diseases in comparison to healthy children in Children Hospital Ain Shams University Hospital. Material and Methods: This study included one hundred twenty-five children, including one hundred chronic liver disease patients (62 males and 38 females) and twenty-five healthy children as controls. The age ranges from 0.25 to 18 years. All children underwent clinical assessment, laboratory investigations and gall bladder ultrasonography. Results: The mean gall bladder anterior wall thickness in patients with gallstones is significantly higher than healthy controls (p-value=0.006). The means of both fasting volume and contraction index were lower in patients with gallstones compared to both patients without gallstones and healthy controls yet they were statistically insignificant. The mean gall bladder anterior wall thickness in patients without gall-stones is higher than healthy controls yet it was statistically insignificant. Conclusion: Chronic liver disease in the pediatric age group is associated with gall bladder sonographic changes. Gall bladder anterior wall thickness was the most significant risk factor for the development of gallstones in children with chronic liver disease.