Small cell carcinoma (SCC) of the gallbladder is an extremely rare tumor. Despite aggressive and varied treatments, its prognosis is poor. A 70-year-old woman undergoing treatment for pneumonia was detected with a gallbladder mass. Radical cholecystectomy was performed and the pathology revealed small cell carcinoma. There were metastases in 2 lymph nodes, scoring T2N1M0, stage IIIB (AJCC 7th). The patient has survived thus far, with subsequent chemotherapy. SCC of the gallbladder has an extremely low incidence and poor prognosis. In some cases, radical surgery with chemotherapy or radiation therapy could increase survival rate of patients.