Xanthogranulomatous cholecystitis (XGC) is an unusual inflammatory disease of the gallbladder that may simulate gallbladder cancer. We report the findings with conventional sonography, endoscopic sonography (EUS), and CT in 3 cases of XGC. EUS could visualize hyperechoic nodules in the gallbladder wall, probably representing xanthogranulomas, but loss of the multilayered structure of the gallbladder wall and infiltration into adjacent organs make differentiating XGC from gallbladder cancer difficult with EUS alone.