One-hundred-and-seventeen patients with histologically proven carcinoma of the gallbladder are reviewed. The majority of the patients presented with advanced disease with extension and metastasis to the liver and to lymph nodes along the common bile duct. Four patients had localized disease recognized at the time of operation; two were treated with cholecystectomy and two with cholecystectomy and hepatic resection. There were no five-year survivals among these patients. Fourteen patients had clinically inapparent carcinoma at the time of cholecystectomy; the diagnosis being established postoperatively by histologic examination of the excised gallbladder. There were two five-year survivors in this group of patients. Both survivors had early papillary carcinoma confined to the gallbladder wall. The remaining patients with inapparent carcinoma died within three years of the time of operation with recurrent carcinoma. The present report and review of the recent literature emphasizes the poor prognosis associated with carcinoma of the gallbladder. Even with apparently localized lesions, the survival rate is extremely poor. Extended resection, while not of proven value, may improve the survival rate.