Acute torsion of the gallbladder is a rare and poorly understood entity. Since it was first described by A.V. Wendel in 1898, approximately 300 cases have been reported in the literature. The treatment of choice remains immediate cholecystectomy, and most cases are diagnosed intraoperatively. There are typical clinical and radiological findings consistent with torsion of the gallbladder that should raise the index of suspicion for this condition preoperatively. We present a case of gallbladder torsion and discuss the pertinent literature. A re-emphasis is placed on the salient clinical features, and the availability of diagnostic tests is stressed. Given the possibility of laparoscopic cholecystectomy and the increasing incidence with which gallbladder torsion is being witnessed today, the importance of a preoperative suspicion is discussed.