A single, large gallstone identified using the Butterfly iQ ultrasound probe in the course of screening performed by nonexpert POCUS operators. This POCUS image demonstrates the classical ultrasound characteristics of gallstones including a highly reflective echo from the anterior surface of the gallstone and marked posterior acoustic shadowing. With change of the subject’s position, the gallstone also typically changes position, which is readily detected during the POCUS examination. POCUS = point-of-care ultrasound.