Polypoid lesions of the gallbladder affect approximately 5% of the adult population. Most affected individuals are asymptomatic, and their gallbladder polyps are detected during abdominal ultrasonography performed for unrelated conditions. Most of these lesions are benign and small sized cholesterol polyps. Yet the surgery is the only way to confirm whether the polyp is benign or not. The most important factors to predict malignancy are the size of the polyp and the patients' age. Most of the polyps less than 10 mm are considered as benign. Ultrasonographic examinations at three-to six-month intervals are warranted to detect rapid growing polyps that should be considered as malignant. However, the imaging follow-up is probably not necessary after 1 or 2 years if there was no increase in the size of the polyp during the initial follow-up period. For polyps greater than 10 mm in diameter, sessile polyps, or patients over 50 years of age, laparoscopic cholecystectomy should be recommended. Polyps associated with symptoms or gallstones are also the indications of surgery.