Objective: To investigate the clinicopathological features, diagnosis, and differential diagnosis of gallbladder sarcomatoid carcinoma. Methods: The clinical manifestations and the microscopic and immunohistochemical characteristics of six patients with gallbladder sarcomatoid carcinoma were analyzed with a follow-up period. Related literature was reviewed. Results:Immunohistochemical markers of gallbladder sarcomatoid carcinoma with spindle cell morphology were epithelial and mesenchymal positivity. Conclusion: Gallbladder sarcomatoid carcinoma could be firmly diagnosed by microscopic morphology and immunohistochemistry. Radical resection is currently used to treat such patients. However, more cases with longer follow-up period are needed to discover better treatments and improve the survival of these patients.