Percutaneous transhepatic cholecyst puncture (PTCCP) is a unique treatment for acute cholecystitis by using of 21 gauge PTC needle with ultrasoundimage control. The procedure is as follows. A percutaneous transhepatic puncture of the gallbladder is made with ultrasonic guidance. After suction removal of the contents of the gallbladder, saline with antibiotics is injected. Finally PTC needle is removed after removal of the injected saline. We carried out PTCCP in 35 patients with acute cholecystitis, and compared its clinical effect with those of PTCCD (46 cases) or conservative treatment of antibiotics administration (38 cases). The treatment of PTCCP removed the clinical symptoms of acute cholecystitis rapidly compared with the conservative treatment and it made the hospitalization shorter compared with the treatment of PTCCD. PTCCP was also performed without any severe complications for patients with underlying diseases. The curative rate of PTCCP was the same as those of other former treatments. It was concluded that PTCCP is a safe, convenient, and useful treatment of acute cholecystitis.