Gross gallbladder wall is an imaging manifestation of chronic cholecystitis. Cholecystitis, gallbladder stones, hepatitis, malnutrition and other diseases can cause gallbladder wall roughness. Normally, the gallbladder is pear-shaped and has the function of concentrating and storing bile. Normally, bile secreted by the liver flows into the gallbladder first and absorbs water through the mucous membrane, so that the bile is concentrated and stored. The wall of the gallbladder is thin and smooth, with a normal wall thickness of 1 – 2 mm, and a thickened gallbladder wall of more than 3.0 mm. Gallbladder wall thickening is commonly seen in diseases such as cholecystitis, hepatitis, hypoproteinemia, heart failure and ascites. In acute cholecystitis, the wall thickens up to 4 mm and the wall is indistinct. If the wall edema is significant, the wall thickness can reach 7.0mm, and the “bilateral” sign can be seen under ultrasound. In chronic cholecystitis, the gallbladder may shrink, the wall may thicken evenly or unevenly, the wall may be rough, and the wall may be accompanied by calcification. In acute and chronic hepatitis, the wall of the gallbladder is thickened and rough. The more severe the jaundice, the more obvious the changes in the wall of the gallbladder. Patients do not have signs and symptoms of cholecystitis. As the hepatitis improves, the gallbladder wall returns to normal. In healthy individuals, ultrasound examination only reveals a gross gallbladder wall, no thickening of the gallbladder wall, no gallbladder stones in the lumen, and no signs and symptoms of cholecystitis such as right upper abdominal pain, no viral hepatitis, no fatty liver, and no alcoholic liver. The diagnosis of cholecystitis cannot be made by the grossness of the gallbladder wall alone, and regular follow-up can be done. Ultrasound examination of the gallbladder wall is mostly suggestive of the presence of chronic cholecystitis, which needs to be diagnosed and treated in combination with clinical symptoms and corresponding etiology.