Background: Gallbladder disease is known to affect a substantial number of people throughout the world. In India, the disease prevalence is on the rise, largely attributable to dietary & lifestyle changes, thus causing a significant disease burden. The purpose of this study is to evaluate the varied histological manifestations of gallbladder pathology and their association with cholelithiasis. Materials & methods: This retrospective study was conducted in a tertiary medical centre in Patna from January 2020 to December 2020. The clinical data and the histopathological changes were evaluated. Results: Of the 156 cases which were studied, 120 cases (77%) had gallstones. The mean age was 47 years. Females had a slight preponderance for gallbladder diseases with the Male: Female ratio being 1:2. 138 cases (88.5%) were diagnosed as chronic cholecystitis. 1.92% cases were diagnosed to have invasive malignancies. Conclusion: A diverse spectrum of diseases affect the gallbladder encompassing inflammatory conditions, parasitic infections, pseudoneoplastic lesions and neoplasms. Routine cholecystectomy specimens should be evaluated meticulously as incidental findingss and diagnosis can be transformative.