Objective: To assess the necessity of routine pathological examination of the gallbladder after laparoscopic cholecystectomy (LC). Methods: All pathological reports of gallbladder over a 5-year period in Department of Pathology of West China Hospital were collected to pick up the cases of incidental gallbladder cancer after LC, and then their clinical data were analyzed. Results: The incidence of incidental gallbladder cancer after LC was 0.28% (36/12 969), among which, 89% (32/36) were adenocarcinoma, and 58.3% carcinoma in situ (Tis) and early gallbladder cancer (T1a and T1b). A suspicious lesion was successfully identified in 34 patients (94.4%) during operation, through intraoperative observation and palpation of the gallbladder specimen combined with preoperative imaging findings, and one Tis case and one T1a case missed identification. Conclusion: A suspicious lesion can be found during operation in a great majority of cases of incidental gallbladder cancer, only a very few cases in very early stages are difficult to be identified, and for these cases, simple cholecystectomy can offer adequate effectiveness. So, the necessity of routine pathological examination of the gallbladder after LC is still questionable.