Gallbladder cancer remains a relatively rare malignancy with a highly variable presentation. Gallbladder cancer is the most common biliary tract malignancy with the worst overall prognosis. With the advent of the laparoscope, in comparison with historical controls, this disease is now more commonly diagnosed incidentally and at an earlier stage. However, when symptoms of jaundice and pain are present, the prognosis remains dismal. From a surgical perspective, gallbladder cancer can be suspected preoperatively, identified intraoperatively, or discovered incidentally on final surgical pathology.