Vasculitis isolated to the gallbladder is uncommon, with few cases reported in the literature. We present a series of nineteen cases of cholecystitis with associated vasculitis. The male to female ratio was 7:12 and average age 75.6 (range 49–97). Most resections were performed for the clinical or imaging impression of cholecystitis, with two removed at the time of a larger resection for malignancy elsewhere. The majority (18/19) of cases showed venous involvement (phlebitis), sparing arteries. Most of the vasculocentric infiltrates were lymphohistiocytic, with five cases showing granulomatous vasculitis. The background mucosal inflammatory pattern in just over half (11/19) of cases showed a lymphofollicular cholecystitis, with the remainder showing typical chronic cholecystitis (6/19) or active chronic cholecystitis (1/19). Two of the cases (2/19) showed striking intraepithelial lymphocytosis. Eight of the samples were acalculous. It is unclear why this pattern occurs, with no patients in this series having a known history of vasculitis, and no association with IgG4 or autoimmune disease identified. The pattern may represent an unusual response to local mucosal injury or to constituents/metabolites in bile. The clinical significance is uncertain. The purpose of this case series is to contribute to the sparse literature describing this striking but uncommon histological reaction pattern.