Xanthogranulomatous cholecystitis is an uncommon variety of gallbladder inflammation. Its histologic appearance is quite specific but its clinical characteristics, prognostic and physiopathologic implications are unknown. The present study has the aim of analyzing a group of 40 patients with xanthogranulomatous cholecystitis and another of 80 patients with non-xanthogranulomatous inflammation. The clinical characteristics, risk factors, morphologic expression, complications and mortality of both groups were compared. Diffuse xanthogranulomatous cholecystitis comprised 1.8% of all cholecystectomies done between January 1976 and July 1987. This variety was more frequent in males (p less than .05) without any specific risk factors. There was a higher frequency of acute pyogenic inflammation sometimes associated to extrinsic compression of the biliary duct and fistulization, but without any difference in the overall complication rate or mortality. We conclude that xanthogranulomatous cholecystitis is a specific entity which occurs with a higher frequency in males and that has a different clinical behavior than that of other types of gallbladder inflammation.