Surgeons have been dependent mainly on the clinical findings in the diagnosis of the empyema of gallbladder requiring a emergent surgical intervention. Ultrasonographic findings of empyema of gallbladder are similar to those of acute cholecystitis, but several finding are more frequently seen in empyema than in acute choecystitis. We reviewed the clinical and ultrasonographic pictures in 15 cases of surgically proven empyema of gallbadder. The results were as follows : 1. Empyema of GB shows relatively high frequency in male and elderly person, compared with acute cholecystitis. 2. Right upper abdminal pain with tendenrness and leukocytosis are constant findings in empyema. 3. Ultrasonographic findings : (1) GB is distended in 80%. (2) GB wallis thickened and ill defined in 80%. (3) internal echo is seen in 93.3% -diffuse(53.3%), localized (20%), or layered(20%). (4) Gallstones are located i CBD causing dilatation proximally.