Abstract 1. 1. Two cases of acute emphysematous cholecystitis are described and added to a total of thirty-four cases collected from the literature. 2. 2. The diagnosis is dependent upon the plain film of the abdomen showing gas in the gallbladder lumen. A gas-fluid level is often demonstrated. 3. 3. A mixture of bacteria may be cultured from the gallbladder. The clostridia group is the one most commonly found. 4. 4. Surgical intervention is the treatment of choice. Interim non-operative treatment of polyvalent gas bacilli antiserums, antibiotics and regulation of fluid and electrolyte balance is necessary.