Last week, a laparoscopic cholecystectomy was successfully performed and the patient was discharged from the hospital. Today, the pathology report was “gallbladder cancer”, which was a real surprise. The patient is a middle-aged woman with chronic cholecystitis for many years and recently felt significant discomfort in the upper abdomen, so she requested surgery to remove her gallbladder and was admitted to the hospital. On ultrasound examination, the gallbladder was atrophied and encapsulated with stones, and no local irregular thickening changes were seen. As a result, the laparoscopic surgery was successful. Although gallbladder cancer is found from time to time, this time it was not expected after all. It seems that more consideration should be given to patients with atrophic cholecystitis combined with gallbladder stones. Indeed, in patients with chronic cholecystitis and gallbladder stones, the chance of gallbladder cancer is significantly higher, and some studies suggest that the incidence can be more than 10 times higher. This should be taken seriously. Patients with chronic cholecystitis and gallbladder stones should be treated more aggressively and timely surgery should be performed to remove the gallbladder.