Aim: Despite surgical and radiological innovations, gallbladdercancer (GC) is usually diagnosed incidentally by the pathologicalexamination of the cholecystectomy specimens, and it is definedas incidental GC (IGC).Methods: Medical files of patients, who underwentcholecystectomy, were analyzed retrospectively. We investigatedthe relationship between clinicopathological features and survivalin patients with IGC.Results: We performed cholecystectomy surgery in 6225 patientsin 20 years. Only 21 patients with IGC were included in thisstudy. The distribution of the tumor stages was as follows: in situcancer (n=1), T1 (n=2), T2 (n=7), and T3 (n=11). Tumor subtypeswere identified as adenocarcinoma (n=16), neuroendocrinetumor (n=2), mucinous carcinoma (n=2), and adenosquamouscarcinoma (n=1). Advanced ‘‘T stage’’, conversion of laparoscopiccholecystectomy to open cholecystectomy (OCC), positivesurgical margins, positive lymphovascular invasion and increasedlevels of pre-operative alkaline phosphatase (ALP) were found tobe associated with poor survival.Conclusion: In case of OCC or high preoperative ALP activityin cholelithiasis, IGC should be kept in mind. Pathology reporton IGC should give information on all histopathologicalprognostic features in order to avoid loss of time associatedwith re-examination of specimens due to absence of sufficientinformation in the initial pathology report and enable the surgicalteam to perform re-operation for T1b tumors or more advancedIGC in a timely fashion.