Purpose Follicular cholangitis is a rare benign inflammatory condition of the bile ducts, which is known to mimic cholangiocarcinoma both clinically and radiologically. It is considered distinct from follicular cholecystitis, an inflammatory condition of the gallbladder. We present the first reported case of concurrent follicular cholangitis and follicular cholecystitis, highlighting diagnostic challenges and potential overlap between these entities. Methodology A case report of a 77-year-old woman with an incidentally detected left intrahepatic bile duct stricture and mildly elevated CA19-9 is presented. Due to persistent concern for cholangiocarcinoma, surgical management with laparoscopic left lateral segmentectomy and cholecystectomy was undertaken. Histopathological and immunohistochemical analyses were performed on resected specimens. Additionally, a literature review of cases reporting follicular cholangitis was conducted. Results Histopathological examination of the liver demonstrated lymphoplasmacytic inflammation with prominent lymphoid follicle formation involving bile ducts of varying calibre, consistent with follicular cholangitis. The gallbladder specimen showed characteristic features of follicular cholecystitis. Based on previous literature, this is the 15th reported case of follicular cholangitis. It is the first case to have identified concurrent follicular cholangitis and follicular cholecystitis. Conclusion Follicular cholangitis remains a rare but important benign differential diagnosis for biliary strictures suspicious for malignancy. This case demonstrates histopathological overlap with follicular cholecystitis and suggests these entities may represent a spectrum of inflammatory biliary disease. Increased awareness may assist in diagnostic consideration and guide future research into shared pathogenesis.