Purpose : To correlate sonographic and pathologic findings of gallbladder adenoma, and to evaluate theclinical significance of sonographic findings. Materials and Methods : Ultrasound findings of twenty gallbladderadenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and wascorrelated with the pathological finding. Results : Among 14 patients, 11 patients had single lesion and 3patients had multiple lesions. Three patients showed 2, 3, and 4 adenomas, respectively. Nine of 20 lesions showedfocal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerouschange. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the meandiameter of adenomas without dysplasia was 8.7mm (3-13mm). The echogenicity of adenoma with focal dysplasia werehyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoicin 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) andstalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showedhistological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, thediameter more than 14 mm on sonography was statistically significant (p<0.005). Also the age of patient wassignificantly different between the two groups (p<0.01), while echogenicity and associated stone were notstatistically significant. Conclusion : As gallbladder adenoma more than 14mm in diameter on US is suggestive ofdysplasia on pathology, so, close follow up US or surgery is recommended.