Hemobilia is a status of bleeding into the biliary tract and occurs when the communication between the biliary tract and blood vessels was injured. Almost all the hemobilia orginated in the gallbladder were related to gallstones and rarely it was reported to be associated with acalculous cholecystitis. A 61-year-old man visited due to continuous right upper quadrant pain and endoscopy revealed oozing blood around the ampulla of Vater. Eighteen days later, laparoscopic cholecystectomy was performed and pathologic examination of the resected gallbladder disclosed acalculous cholecystitis and no stone was found. We report a case of hemobilia with acalculous cholecystitis. (Korean J Gastrointest Endosc 2005;31:198203)