Mud in the gallbladder refers to mud-like stones, which have diverse etiologies, such as geography, race, obesity, dietary habits, etc. Stones in the gallbladder are categorized as cholesterol stones, bile pigment stones, mixed stones and others such as calcium carbonate stones; bile pigment stones are mostly silt-like or gravelly, often multiple, and mostly found in the bile ducts. There are two types of bile pigment stones: calcium bile pigment stones and melanin stones. The former is a combination of free bile pigment and calcium and other metal ions, mainly in the intra- and extra-hepatic bile ducts, the stones can be granular, elongated, or even cast tubular, with varying sizes, and are mostly multiple. Melanoliths composed of black bile pigment polymorphs, mucus glycoproteins, and various calcium salts almost always occur in the gallbladder. Any factor that affects the ratio of cholesterol to bile acid-phospholipid concentration and contributes to cholestasis may lead to gallbladder stone formation, and its etiology is complex. Such as geographical factors, racial factors, estrogen, obesity, pregnancy, high-fat diet, long-term parenteral nutrition, diabetic hyperlipidemia, some gastrointestinal diseases and postoperative surgery, hemolytic anemia. In our country, it may also be related to dietary habits. It is recommended to actively seek medical advice and follow the doctor’s instructions.