A review of the most relevant clinical data of patients with primary carcinoma of the gall bladder referred to our hospital over a 16-year-period has indicated that this is the third most common and aggressive cancer of the gastrointestinal tract. The disease occurs predominantly in elderly females who often present with extremes of clinical symptoms indicating benign biliary disease on the one hand and incurable malignant disease on the other. Laboratory and roentgenographic data tend to confirm the clinical diagnosis of this almost entirely incurable disease. The overall 5-year survival of the patients with primary carcinoma of the gall bladder is less than 1%; a majority of the patients are dead in less than 6 months.