We propose the following surgical indications according to the high risk factors for malignancy of gallbladder polyp-like lesions: Gallbladder polyps (1) solitary lesions, larger than 10 mm, with thick tips, especially in the neck of the gallbladder, age >50 years. (2) Multiple lesions with gallbladder stones, symptomatic and older than 50 years old. (3) Single lesion, less than 10 mm, asymptomatic, age less than 50 years, observation and follow-up are allowed; lesions that increase in size or change in morphology should be treated surgically. (4) Doppler ultrasound examination of the lesion with abundant blood supply suggests a malignant neoplasm. (5) CEA (tumor marker), the measured value is significantly increased and other gastrointestinal tumors are excluded. (6) Gallbladder polyp-like lesions with significant symptoms and recurrent recurrence. (7) Asymptomatic patients with diameter less than 5 mm should be followed up at intervals of 3 to 5 months. Once the lesion is enlarged or symptomatic, surgery should be performed.