Pregnancy complicated with gallbladder disease stone has an incidence of 2-14%, and more than 30% of patients do not respond to medical treatment; therefore, in order to reduce the morbidity and mortality in fetus and mother, surgical management would be required. The current use of ultrasound of high resolution has facilitated the diagnosis and also, in the present clinical case, this imaging modality allowed us to suspect the unusual diagnosis reported, that corresponds to a female of 34 years old with 33 weeks of pregnancy, complicated with symptomatic gallbladder disease stone, whose pain was intractable at the expectant management. The clinical diagnosis was corroborated by ultrasound and the report was: lithiasis, biliary sludge and an intragallbladder image of bilobular polypoid. The patient was submitted to cholecystectomy by laparotomy, whose histopathologic findings were: cholelithiasis and in situ gallbladder adenocarcinoma with an exophytic growing variety. The purposes of this article are to report a case and to review the literature.