A 78-year-old woman who had been diagnosed with a gallbladder polyp presented to the emergency department with epigastric pain and dizziness. Nineteen months prior to presentation, a 5 mm-sized enhancing polyp of the gallbladder was first detected on an abdominal computed tomography (CT) scan (Fig. 1A). Seven months prior, the polyp had grown to 2.5 cm (Fig. 1B). One month prior, the polyp had grown to 3.5 cm, and focal low-density nodular lesions with pericholecystic infiltration were newly detected (Fig. 1C). At the initial diagnosis, the patient had refused a cholecystectomy. On presentation, physical examination revealed conjunctival pallor and epigastric tenderness. The patient denied any history of hematochezia or hematemesis. A complete blood count revealed anemia (hemoglobin level, 7.8 g/dL). The patient’s blood chemistries including liver function test were normal. CT of the abdomen disclosed an extremely distended and edematous gallbladder with a large hematoma in the lumen (Fig. 1D). Ultrasound-guided percutaneous gallbladder drainage was first performed, followed by laparoscopic cholecystectomy.