Gallbladder cancer is a highly invasive malignant tumor with the characteristics of early lymph node metastasis, direct infiltration of hepatic tissues, easy to occur abdominal implantation and hematogenous metastasis. Its mortality rate is high, 5-year survival rate ﹤5%, and average survival period is 5-8 months. Because the long-term curative effect is worse than that of liver cancer and pancreatic cancer, it is the king of cancers in name. Risk factors include: elderly women, large stones, adenomatous polyps. The etiology of primary gallbladder cancer is still unknown. However, it has become a consensus that cholecystitis, cholelithiasis, bacterial infections, bile acid metabolism disorders, and gallbladder mucosal hyperplasia are associated with the development of gallbladder cancer. In addition, high-fat diet, smoking and alcoholism are also risk factors for gallbladder cancer. The ratio of male to female incidence of gallbladder cancer is 1:2.7, and the average age of incidence is 65.2 years. Early stage of gallbladder cancer often has no specific symptoms, and when found, it is mostly in advanced stage, and only those who can be surgically resected can have a longer survival period. According to domestic statistics, gallbladder cancer accompanied with gallbladder stones accounted for 31.6% of patients; the occurrence of gallbladder cancer is closely related to the size of stones, the incidence rate of gallbladder cancer is 1.0% in the case of stones with diameter ﹤10mm, 2.4% in the case of stones with diameter of 20~22mm and 10% in the case of stones with diameter >30mm. Gallbladder polyps are divided into cholesterol polyps and adenomatous polyps, adenomatous polyps, if single, broad-based polyps, diameter > 1 centimeter, the chance of malignant transformation will be greatly increased. Overseas studies have shown that there may be a relationship between benign polyps of the gallbladder and gallbladder adenomas and gallbladder cancer in the order of onset, and it usually takes 3 to 10 years for atypical hyperplasia to develop into cancer. Cholesterol polyps, on the other hand, do not become cancerous, so this type of patient can relax. In conclusion, when encountering middle-aged and elderly women over 60 years of age with filled gallstones or gallbladder polyps over 1 cm or porcelain gallbladders, regular close review or even prophylactic gallbladder removal needs to be emphasized. If the patient undergoes surgery for stones or polyps, rapid intraoperative pathologic examination should be sent to avoid secondary surgery for cancer diagnosis after surgery.