Xanthogranulomatous cholecystitis (XGC) is an uncommon lesion which may form a tumor-like mass in inflamed gallbladders. In a review of 44 cases there were 40 associated with gallstones which had been incarcerated in the neck of the gallbladder, 10 with past histories of abdominal surgeries, 15 with diabetes mellitus, three with carcinomas in the neck of the gallbladder and four with carcinomas in the other organs. Radiologically the differential diagnosis of gallbladder cancer and XGC was difficult in several cases. Thirty five cases of XGC have been diagnosed as chronic cholecystitis and 7 have been mistaken for feature of XGC in the contrast enhancement CT that is, detection of an intramural low density mass with continuously enhanced internal membraneous layer of the gallbladder wall. In view of the clinico-pathological findings of XGC, the lesions appear to result from intramural extravasation of bile and subsequent xanthogranulomatous reaction under obstructive conditions in the neck of the gallbladder. We conclude that XGC is not an uncommon special type of cholecystitis but an accompanied lesion sometimes seen in a kind of cholecystitis.