Hemorrhagic cholecystitis is a rare and potentially fatal complication of biliary tract disease. Nontraumatic hemorrhagic cholecystitis is related to a variety of etiologies. Here, the authors reported an elderly patient who developed hemorrhagic cholecystitis after heparin and aspirin usage for unstable angina. Laparoscopic cholecystectomy was performed with the histopathology report disclosing adenocarcinoma in situ. As demonstrated in this case, underlying malignant changes in its early stage increase the risk of bleeding concomitant with anticoagulation usage.