&NA;A case of cholecystocolonic fistula and sigmoidal obstruction is presented. Initial surgical management was accomplished by colotomy with lithotomy, cholecystectomy, and concomitant exteriorization of the fistula site in the colon as a diverting colostomy. The authors recommend routine use of exteriorization of a fistula site as a diverting colostomy with cholecystectomy or cholecystostomy for initial treatment for this unusual manifestation of biliary disease.