Intervention in the gallbladder includes therapy for both acute and chronic gallbladder disease. Although drainage for acute cholecystitis has been described by several investigators, the future seems to be in removal of calculi in symptomatic patients without acute cholecystitis. The technique for acute gallbladder drainage is described in detail using ultrasound guidance with or without fluoroscopy; for symptomatic gallstones, the clinical and technical aspects are described. We also discuss in detail the totally new concept for gallstone removal and the initial patient work using rotational contact lithotripsy with the Kensey-Nash device.