Gallbladder volvulus is a rare condition that is difficult to diagnose pre- operatively. It occurs as a result of the gallbladder rotating on its own pedicle either 180 degree or >180 degree clockwise or counterclockwise. It is more prevalent in elderly women >70 years or young men <18 years of age. The exact cause of gallbladder volvulus is not known but there have been different propositions regarding this phenomenon ranging from anatomical variation, presence of cholelithiasis, physiological, mechanical, or hormonal risk factors. Patient present with signs and symptoms similar to acute cholecystitis which may result in a delay to diagnosis and treatment. Gallbladder volvulus is a key differential diagnosis in elderly women with imaging suggestive of acute acalculous cholecystitis or in patient clinically not responding to antibiotic treatment. A delay in diagnosis results in an ischemic gallbladder, necrotic gallbladder, biliary peritonitis, biliary perforation, or mortality.