Gallbladder abdominal wall fistula is usually due to the acute cholecystitis with-out timely treatment, which leads the formation of abscess around the gallbladder, the gallbladder adhering to the abdominal wall and the abscess infiltrating into the skin to form a spontaneous abdominal wall fistula. Patient with gallbladder abdominal wall fistula may have the symptoms of cholecystolithiasis and acute cholecystitis. Ultrasound examination can detect the situation of gallbladder conveniently, including the internal echo after formation of abscess, the connection between the gallbladder and abdominal cavity, and the blood flow signal, to clarify the diagnosis for the subsequent treatment. The authors share the diagnosis and treatment experiences of an elderly patient with gallbladder abdominal wall fistula.