Gallbladder cancer is an aggressive tumor with a poor prognosis. The incidence peaks at 70–75 years, with a female preponderance (3:1, female:male ratio). There is a strong correlation with gallstones and longer duration of cholelithiasis and larger size of stone (>3 cm) further increases the risk. The majority (60%) of gallbladder cancers arise in the fundus of the gallbladder, 30% occur in the body, and 10% in the neck. The extent of the gallbladder cancer and the mode of its detection decide the treatment modality. With laparoscopic cholecystectomy becoming the gold standard for treating gallstones, the incidental discovery of gallbladder carcinoma peroperatively or postoperatively on histopathology is a new phenomenon, which needs to be addressed. This chapter covers the Tis and Tia gallbladder carcinoma, incidental gallbladder cancer, lymph node status, and adjuvant therapy.