Spontaneous external biliary fistula or cholecystocutaneous fistula is defined as the rupture of the gallbladder through all layers of the abdominal wall, with development of a fistulous tract to the skin without prior biliary surgery or trauma. We report the case of an octogenarian woman with debilitating comorbidities and consequently immunosuppression who presented with spontaneous external biliary fistula and a history of ERCP three months before, a procedure that was carried out with no apparent immediate complications.