Gallbladder cancer (GBCA) is the most common malignancy of the biliary tract, representing 80%–95% of biliary tract cancers worldwide. It is also the most aggressive cancer of the biliary tract with the shortest median survival from the time of diagnosis. The symptoms at presentation are non-specific and are most often related to adjacent organ invasion, contributing to advanced staging and poor prognosis at the time of diagnosis. Recent imaging studies allow for an early diagnosis of malignancy, though the findings may be indistinguishable from inflammatory disease processes affecting the gallbladder. Ultrasonography (US) is the most commonly employed initial imaging technique for gallbladder evaluation. Gallbladder wall thickening is the most common finding of early GBCA, but US is non-specific. Recently, contrast-enhanced ultrasound has also been used in differentiating benign from malignant disease. Multidetector computed tomography is the most useful and preferred imaging technique in evaluation of GBCA. It provides relatively increased sensitivity, though it is not entirely specific and may be difficult in differentiating GBCA from xanthogranulomatous cholecystitis. Due to its superior soft tissue resolution, magnetic resonance imaging provides excellent delineation of gallbladder and biliary tree involvement. In addition, diffusion-weighted and perfusion imaging provides a useful problem-solving tool for diagnosing the malignant potential of non-specific gallbladder lesions and detection of metastases. Positron emission tomography has a role in detection of distant metastases and follow-up of patients following treatment for malignancy.