The clinical characteristics and the microscopic and immunohistochemical characteristics of two cases with gallbladder carcinosarcoma and sarcomatoid carcinoma were analyzed with a follow-up period. Related literature was reviewed. Two cases were found with abdominal discomfort. Microscopically, gallbladder carcinosarcoma and sarcomatoid carcinoma all showed neoplasm of carcinoma and sarcoma simultaneously coexisted, but no transitional areas were detected between carcinoma and sarcoma of gallbladder carcinosarcoma, its immunohistochemical markers with spindle cell morphology were mesenchymal positivity. Sarcomatoid carcinoma showed that between carcinoma and sarcoma existed transitional areas and its immunohistochemical markers of sarcoma with spindle cell morphology were epithelial and mesenchymal positivity. Gallbladder carcinosarcoma and sarcomatoid carcinoma both are rare tumors with high malignant neoplasm, which could be firmly diagnosed by sufficient sections and immunohistochemistry (IHC), also needed to be discriminated from each other and others similar diseases.