Objective: To explore the clinical characteristics treatment and prognosis of incidental gallbladder cancer (IGBC). Methods: The clinical and pathological data of 47 patients with IGBC from Jan 2004 to Jun 2014 were retrospectively summarized, in which different treatment and factors affecting prognosis were analyzed. Results: There were 14 patients with stage T1a, 15 patients with stage T1b, 13 patients with stage T2, 4 patients with T3. The 1-, 3-, and 5-year overall survival rate were respectively 94.7%, 75.8%, and 57.2%. Two cases with incision metastasis were found postoperatively. Multivariate analysis showed that T stage, surgical type and histological differentiation were the independent factors for prognosis of IGBC (P<0.05), The difference in survival rate between patients who received pure cholecystectomy and those who received radical surgery was not significant in stage T1b (P=0.278), but there was significant difference of survival between the two surgical type in stage T2 (P=0.042). Conclusion: Patients with IGBC showed early stage. Frozen section examination should be performed for the patients with high risk factors. Simple cholecystectomy is appropriate for T1a patients, whereas radical resection is recommended for patients with stage T1b or more advanced IGBC.