This study was performed to assess the usefulness of percutaneous gallbladder aspiration for the treatment of acute cholecystitis. Twenty acute cholecystitis patients treated by percutaneous gallbladder aspiration were enrolled in this study and retrospective analysis was performed. Percutaneous gallbladder aspiration was carried out under local anesthesia with ultrasound guidance and 21G puncture needle by percutaneous trans-hepatic approach. Successful therapy was achieved in 18 patients (90%) and the time required to be successful pain control was 0.5-31.5 hours (mean 13.8 hours). 16 patients with mild acute cholecystitis were all successfully treated by the procedure, but two of four patients with moderate acute cholecystitis were failed in treatment There was neither mortality nor major complication related with the procedure. 10 patients (50%) were cured by the procedure and antibiotics medication, and they could be discharged without surgery In addition. 8 of 10 surgical patients (80%) underwent elective surgery and they were able to avoid the risk of emergent or early surgery. Therefore. percutaneous gallbladder aspiration was though to be a useful alternative treatment in the acute cholecystitispatients who couldn’t undergo surgery for some reason. it could be also temporary treatment to avoid relative high-risk emergent or early surgery.