This study aims to evaluate the prevalence, risk factors, and relative risk of gallstones and associated disease in patients with ulcerative colitis (UC). Medical records of 311 patients diagnosed with UC between January 2004 and February 2015 were reviewed retrospectively. To assess relative risk, 622 patients matched by age, sex, and body mass index were included as a control group. Gallstones were detected in 8% (25/311) of UC patients and in 3.9% (24/622) of the control group. Prevalence was significantly higher in the UC group (odds ratio [OR], 2.178; P = .007). Mean age of gallstone patients was 57.1 ± 17.8 years in the UC group, and mean disease duration of UC was 67.2 ± 38.8 months. The male-to-female ratio of gallstone patients in the UC group was 2.13:1. Mean interval from diagnosis of UC to detection of gallstones was 17.8 ± 30 months. Six UC patients with gallstones underwent cholecystectomy or endoscopic retrograde cholangiography for symptomatic disease and complications. In univariate analysis, diabetes, hypertension, age ≥65 years, and history of more than 3 admissions were significantly associated with gallstone in UC patients. In multivariate analysis, age ≥65 years (OR, 2.655; P = .033) and hospitalization ≥3 times (OR, 4.1; P = .001) were statistically significant risk factors for gallstones in UC patients. This study shows that UC patients have a significantly higher risk of gallstones compared to the general population (OR, 2.178; P = .007), especially those who are older, with a history of multiple admissions.