Experience in observation and treatment of 193 patients with polypous lesions of the gallbladder (PLGB) was analyzed. The patients were divided into 2 groups: group 1 consisted of 102 operated patients including ones with polypous cholesterosis (59), hyperplastic polyps (21), adenomatous polyps (19), polyform cancer (3). Group 2 consisted of 91 non-operated patients. The structure of the disease was studied. Clinical and morphological classification of PLGB, indications for surgery and follow-up were developed. Proposed algorithm of diagnostic and treatment policy permits to reduce surgical activity in PLGB by 68.6% without detriment for diagnosis and treatment of polyform cancer of the gallbladder.